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2.
Clin Oral Investig ; 2021 Jul 21.
Artigo em Inglês | MEDLINE | ID: mdl-34286398

RESUMO

OBJECTIVES: This two-arm, parallel-group, tooth-randomised, controlled noninferiority clinical trial aimed to compare survival rates between the sealing and restoring of cavitated occlusal carious lesions in dentine [International Caries Detection and Assessment System (ICDAS) 5] of deciduous molars using resin-modified glass-ionomer cement (RMGIC) and to assess caries progression radiographically. MATERIALS AND METHODS: A total of 68 molars with ICDAS 5 occlusal lesions were randomly allocated into two groups, a sealing group (n = 31), in which RMGIC was placed directly over the carious lesion, and a restoration group (n = 37), in which a restoration with the same material was placed after selective caries removal. During the baseline and follow-up visits, dental caries was registered and caries activity was assessed according to a visuotactile criterion. At baseline, patient caries status (dmf-t) and cavity depth and extent (mesiodistal and buccolingual) were measured before RMGIC placement. An independent and blinded examiner evaluated the treated teeth using the USPHS criteria after one and two years. Standardised interproximal radiographs were taken for caries progression assessments. RESULTS: During the follow-up period, no lesion progression was observed radiographically. After one year (n = 60; 27 sealed and 33 restored) and two years (n = 48; 23 sealed and 25 restored) of follow-up, the treatment success rates were 78.8% and 76.0% in the restoration group and 59.3% and 47.8% in the sealing group, respectively. Multivariate Cox regression showed that lesions smaller than 2 mm in the mesiodistal extent were less prone to fail after one year (p = 0.03). However, survival curves (log-rank test) were statistically significantly different only after two years (p < 0.001). CONCLUSIONS: Sealing ICDAS 5 occlusal lesions of deciduous molars using RMGIC achieved lower survival rates than restorations. Both sealing and restoration effectively arrested caries progression for two years. Clinical relevance Sealing dentine carious lesions can be effective for treating lesions involving the inner and outer half of the dentine. Ultraconservative treatments can arrest carious lesions presenting obvious cavitation in primary molars. TRIAL REGISTRATION: ReBEC Register no. RBR-225n35.

3.
Braz Oral Res ; 35: e072, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34161411

RESUMO

This paper intends to describe the demand for referrals to the stomatology service requested by the medical teams for inpatients in a reference hospital in the south of Brazil. This research is a retrospective cross-sectional descriptive study focusing on data collection and assessment of information about referrals to the stomatology unit carried out from January 2008 to December 2018. All information was obtained from the hospital management software database, then transferred and analyzed individually for descriptive statistics. A total of 4433 cases were referred to the stomatology team, with an average of 403 cases by year. Hematology/hemato-oncology (37.3%) was the specialty asking for the majority of the referrals, followed by Oncology (20.4%) and Pneumology (8.2%). The mean patients' profile was males (55.5%), receiving a diagnosis of oral mucositis (43.5%), and with the first and second decades of life being the most prevalent ones (34.9%), with a mean age of 34.8±22.3 years. The most common treatment performed by the stomatology team was the photobiomodulation therapy (44.8%). This retrospective study demonstrated the important profile of the stomatological care in hospitalized patients from a specific hospital, especially referred by the hematology/hemato-oncology team. These results evidenced the importance of the stomatology specialty in the hospital environment.


Assuntos
Medicina Bucal , Adolescente , Adulto , Brasil , Criança , Estudos Transversais , Hospitais , Humanos , Masculino , Pessoa de Meia-Idade , Encaminhamento e Consulta , Estudos Retrospectivos , Adulto Jovem
4.
Int Dent J ; 71(3): 206-213, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34024330

RESUMO

OBJECTIVE: To evaluate the association of dental pain with time living on the street in a sample of homeless people in the city of Porto Alegre, Brazil. METHODS: A cross-sectional study was carried out with homeless people who accessed social services in 2017. A questionnaire was administered covering socioeconomic variables and including questions about general health, use of tobacco/alcohol/drugs, use of dental services and history of dental pain. The decayed, missing, and filled teeth (DMFT) index was calculated in an oral examination. The association between socioeconomic characteristics, health status, time of homelessness and dental pain was evaluated using chi-square, t-, and Mann-Whitney tests. RESULTS: A total sample of 214 homeless people was surveyed. Most were male (76.2%), had a low level of education (67.6%) and experienced many episodes of dental pain during life (91.0%). The last episode of pain was moderate or intense (79.7%) and do-it-yourself measures for pain relief were preferred (62.3%). Individuals who were homeless for longer than 1 year had more dental pain in the past (P < 0.001), more frequency of a recent episode of dental pain (P = 0.03), and sought a dentist or healthcare service to relieve pain less frequently (P = 0.03). CONCLUSIONS: Dental pain is frequent in the context of homelessness and does not necessarily result in seeking dental services, even where there is universal oral health care.


Assuntos
Cárie Dentária , Pessoas em Situação de Rua , Adulto , Brasil/epidemiologia , Estudos Transversais , Índice CPO , Feminino , Humanos , Masculino , Saúde Bucal , Dor
5.
Dysphagia ; 2021 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-34019177

RESUMO

Voice change post-swallow, observed during a clinical swallow examination, is often used as a clinical indicator of dysphagia risk. However, there has been limited research that evaluated the level of agreement between voice change and swallow dysfunction reported to date. This systematic review aims to investigate existing evidence relating to the relationship between vocal change post-swallow and swallow deficits identified on a Videofluoroscopic Swallow Study (VFSS). The studies were selected by two independent evaluators for inclusion, without restriction on language or date of publication and the methodological quality and the risk of bias were assessed using QUADAS-2. Following the PRISMA recommendation, 271 articles were analyzed, of which 17 were included in the study. Of these, the methodology described in five studies employed voice analyses using only acoustic methods, seven others conducted only auditory-perceptual analyses, and five other studies used both. Across the studies there was no homogeneity in the voice quality parameters assessed, analytic methods used, and results obtained. Forty seven per cent of the studies presented a high risk of bias in the analysis of vocal quality due to lack of clarity and blinding of VFSS. There was no homogeneity in the choice of consistencies evaluated during swallowing, as well as standardization of the outcome investigated in VFSS without a vocal parameter attributable to accurate detection in each outcome. It is not possible to obtain a consensus regarding the recommendation of the use of vocal evaluation as an accurate method for identifying swallowing alterations due to heterogeneity of the vocal evaluation methods, the outcomes evaluated in the VFSS examination, heterogeneity in food and liquid consistencies, and the methodological quality of the studies.

6.
Anal Chim Acta ; 1167: 338566, 2021 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-34049626

RESUMO

Here, a novel electrically conductive thermoplastic material composed of graphite/acrylonitrile butadiene styrene (G/ABS) is reported for the first time. This material was explored on the production of 3D printing-based electrochemical sensors with enhanced sensitivity using a novel fabrication approach. The developed G/ABS electrodes showed lower charge transfer resistance (157 vs. 3279 Ω), higher electroactive area (0.61 vs. 0.19 cm2) and peak currents ca. 69% higher when compared with electrodes fabricated using carbon black/polylactic acid (CB/PLA) commercial filament, which has been widely explored in recent literature. Moreover, the G/ABS sensor provided satisfactory repeatability, reproducibility and stability (relative standard deviations (RSDs) were 1.14%, 6.81% and 10.62%, respectively). This improved performance can be attributed to the fabrication protocol developed here, which allows the incorporation of greater amounts of conductive material in the polymeric matrix. The G/ABS electrode also required a simpler and quicker protocol for activation when compared to CB/PLA. As proof of concept, the G/ABS sensor was employed for electroanalytical quantification of paracetamol (PAR) in pharmaceutical products. The linear concentration range was observed from 0.20 to 30 µmol L-1 and the limit of detection achieved was 54 nmol L-1, much lower than several recent studies dealing with the same analyte. The sensitivity of the G/ABS electrode regarding PAR was also far better when compared to CB/PLA sensor (0.50 µA/µmol L-1 vs. 0.12 µA/µmol L-1). Analyses in commercial pill samples showed good accuracy (recoveries ca. 108%) and precision (RSDs < 5%), suggesting great potential for use of this novel conductive thermoplastic in electroanalytical applications based on 3D printing.

7.
Braz Oral Res ; 35: e038, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33909860

RESUMO

A randomized controlled parallel clinical trial was conducted to evaluate the efficacy of the association of 1.23% topical professional acidulated phosphate fluoride (APF) gel with oral hygiene and dietary instructions on the arrest of active non-cavitated lesions in permanent, mixed, and temporary dentition in children between 3 and 12 years of age. Ninety-eight caries-active children were randomly divided into two groups: a fluoride gel group (n = 49) and a non-fluoridated gel group (n = 49). Each group received up to eight weekly applications of gel, weekly professional toothbrushing with oral hygiene instructions and dietary counselling. Caries lesions were assessed qualitatively through visual-tactile criteria performed in three stages: initial, intermediate, and final. Regression models were applied to identify risk indicators for caries control. Between-group comparison regarding the time taken to arrest the lesions was performed using Chi-squared and Fisher's exact tests. Seventeen children did not receive the allocated intervention, and one was lost to follow-up (n = 80). There was no difference between the control and placebo groups regarding the time to the arrest of the lesion (p >.05). The treatments showed similar results without significant statistical difference (p = 0.33; 95%CI: 0.32-1.48). No adverse effects were observed. It can be concluded that no additional effect of the association of 1.23% APF gel with oral hygiene using fluoride dentifrice and dietary instructions on the arrest of active non-cavitated lesions could be established. We can also confirm the importance of toothbrushing frequency and, consequently, the visible plaque reduction in the control of caries activity. RBR-37V5S3.


Assuntos
Fluoreto de Fosfato Acidulado , Cárie Dentária , Cariostáticos/uso terapêutico , Criança , Cárie Dentária/prevenção & controle , Esmalte Dentário , Humanos , Dente Decíduo , Escovação Dentária
8.
Braz. oral res. (Online) ; 35: e072, 2021. tab, graf
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-1278589

RESUMO

Abstract This paper intends to describe the demand for referrals to the stomatology service requested by the medical teams for inpatients in a reference hospital in the south of Brazil. This research is a retrospective cross-sectional descriptive study focusing on data collection and assessment of information about referrals to the stomatology unit carried out from January 2008 to December 2018. All information was obtained from the hospital management software database, then transferred and analyzed individually for descriptive statistics. A total of 4433 cases were referred to the stomatology team, with an average of 403 cases by year. Hematology/hemato-oncology (37.3%) was the specialty asking for the majority of the referrals, followed by Oncology (20.4%) and Pneumology (8.2%). The mean patients' profile was males (55.5%), receiving a diagnosis of oral mucositis (43.5%), and with the first and second decades of life being the most prevalent ones (34.9%), with a mean age of 34.8±22.3 years. The most common treatment performed by the stomatology team was the photobiomodulation therapy (44.8%). This retrospective study demonstrated the important profile of the stomatological care in hospitalized patients from a specific hospital, especially referred by the hematology/hemato-oncology team. These results evidenced the importance of the stomatology specialty in the hospital environment.


Assuntos
Humanos , Masculino , Adolescente , Adulto , Adulto Jovem , Medicina Bucal , Encaminhamento e Consulta , Brasil , Estudos Transversais , Estudos Retrospectivos , Hospitais , Pessoa de Meia-Idade
9.
Biota Neotrop. (Online, Ed. ingl.) ; 21(3): e20200993, 2021. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1285464

RESUMO

Abstract: The ecological domain of the Atlantic Forest holds a remarkable diversity of anurans with a great degree of endemism, most of which are distributed in high altitude areas, mostly represented by the mountains along the Mantiqueira Complex and Serra do Mar. Despite its biological importance, the region still shows a gap of sampling concerning the amphibians. Thus, we present the first systematic survey of the anuran fauna from Área de Proteção Ambiental Boqueirão da Mira (APABM), in the region of Zona da Mata, Minas Gerais state, Brazil. Two fieldwork expeditions were performed where fifteen sample points were inventoried through active night search and day audiovisual survey in breeding and foraging sites. The anuran fauna of the APABM presented 43 species distributed in 12 families, with the Hylidae family being the richest (17 species). Besides, four species had their distribution increased due to our findings (Hylodes perere, Physalaemus rupestris, Bokermannohyla ibitipoca and Ololygon cosenzai), all of them as endemic to the Mantiqueira Complex. This study revealed that the APABM has a great diversity of anuran species, more representative than adjacent regions such as the Parque Estadual Ibitipoca and close to the richness presented for the Parque Estadual Serra Negra da Mantiqueira. This work demonstrates the great importance of the APABM for conservation, highlighting it as an area of high diversity of the regional anuran species.


Resumo: O domínio ecológico da Mata Atlântica possui uma notável diversidade de anuros com grande grau de endemismo, a maioria distribuídos em áreas de alta altitude, representadas principalmente pelas montanhas ao longo da Serra da Mantiqueira e Serra do Mar. Apesar de sua importância biológica, a região ainda mostra uma lacuna de amostragem em relação aos anfíbios. Assim, apresentamos o primeiro levantamento sistemático da anurofauna da Área de Proteção Ambiental Boqueirão da Mira (APABM), na região da Zona da Mata, Minas Gerais, Brasil. Foram realizadas duas expedições de campo, onde quinze pontos amostrais foram inventariados por meio de procura ativa noturna e diurna audiovisual em locais de reprodução e forrageio. A anurofauna da APABM apresentou 43 espécies distribuídas em 12 famílias, sendo a família Hylidae a mais rica (17 espécies). Além disso, quatro espécies tiveram sua distribuição ampliada devido aos nossos achados (Hylodes perere, Physalaemus rupestris, Bokermannohyla ibitipoca e Ololygon cosenzai), todas elas sendo endêmicas do Complexo da Mantiqueira. Este estudo revelou que a APABM possui uma grande diversidade de espécies de anuros, mais representativas do que regiões adjacentes como o Parque Estadual do Ibitipoca e próximas à riqueza apresentada pelo Parque Estadual da Serra Negra da Mantiqueira. Este trabalho demonstra a grande importância da APABM para a conservação, destacando-a como uma área de alta diversidade de espécies de anuros regionais.

11.
Int Dent J ; 2020 Oct 23.
Artigo em Inglês | MEDLINE | ID: mdl-33096587

RESUMO

OBJECTIVE: To evaluate the association of dental pain with time living on the street in a sample of homeless people in the city of Porto Alegre, Brazil. METHODS: A cross-sectional study was carried out with homeless people who accessed social services in 2017. A questionnaire was administered covering socioeconomic variables and including questions about general health, use of tobacco/alcohol/drugs, use of dental services and history of dental pain. The decayed, missing, and filled teeth (DMFT) index was calculated in an oral examination. The association between socioeconomic characteristics, health status, time of homelessness and dental pain was evaluated using chi-square, t-, and Mann-Whitney tests. RESULTS: A total sample of 214 homeless people was surveyed. Most were male (76.2%), had a low level of education (67.6%) and experienced many episodes of dental pain during life (91.0%). The last episode of pain was moderate or intense (79.7%) and do-it-yourself measures for pain relief were preferred (62.3%). Individuals who were homeless for longer than 1 year had more dental pain in the past (P < 0.001), more frequency of a recent episode of dental pain (P = 0.03), and sought a dentist or healthcare service to relieve pain less frequently (P = 0.03). CONCLUSIONS: Dental pain is frequent in the context of homelessness and does not necessarily result in seeking dental services, even where there is universal oral health care.

12.
Rev Bras Epidemiol ; 23: e200074, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32638857

RESUMO

OBJECTIVE: Communication barriers are the main obstacle for people with sensory disabilities (visual and hearing) to access health services. This study aims to describe the presence of facilitators of communication of basic health units in Brazil and to verify its associated factors. METHODS: Cross-sectional multilevel study, of 38,811 health units in 5,543 municipalities between 2012 and 2013, collected in the National Program for Improving Access and Quality in Primary Care (Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica - PMAQ-AB). The outcome was defined by grouping facilitators of communication (braille material; hearing resources; visual communication; accessible list of service; professionals to welcome users with sensory disabilities). The two levels were structured, using the variables: level I (contextual): macro region, population size, and GDP per capita; and level II (service): extended professional team (psychologist/social worker); service shifts; welcoming room; publishing of service hours; presence of physical access facilitators. Multilevel Poisson regression with hierarchical modeling was used in both stages. RESULTS: The presence of facilitators of communication is small in Brazilian health units (32.1%). It is more frequent in the municipalities with a higher GDP (RP = 1.02, 95%CI 0.92 - 1.12) and population size (RP = 1.25, 95%CI 1.02 - 1.52). CONCLUSION: Welcoming users is the main access facilitator and should be the focus of initiatives to improve health care for disabled persons. Universal access with adequate services, removal of communication barriers and encouragement to properly welcome users must be promoted.


Assuntos
Barreiras de Comunicação , Acesso aos Serviços de Saúde , Pessoas com Deficiência Auditiva , Atenção Primária à Saúde , Pessoas com Deficiência Visual , Brasil , Cidades , Estudos Transversais , Humanos , Análise Multinível
13.
Aletheia ; 53(1): 68-83, jan.-jun. 2020. ilus, tab
Artigo em Português | LILACS-Express | LILACS, Index Psicologia - Periódicos | ID: biblio-1278231

RESUMO

O objetivo da pesquisa foi identificar a organização dos serviços de atenção à saúde bucal, na perspectiva das Redes de Atenção à Saúde, dos municípios da região metropolitana de Porto Alegre. Trata-se de uma pesquisa transversal de caráter descritivo. Foi realizado um censo entre as equipes de saúde bucal que participaram do segundo ciclo do Programa de Melhoria do Acesso e da Qualidade da Atenção Básica. Neste estudo, foram inseridas 125 equipes de saúde bucal da região metropolitana de Porto Alegre. Foi observado desempenho regular no programa, por supremacia das equipes de saúde bucal. O município de Gravataí apresentou as melhores estimativas de desempenho entre os avaliados no estudo. Com a realização deste mapeamento pode-se concluir que a rede de atenção à saúde bucal da região metropolitana de Porto Alegre está fortalecida quanto aos princípios ordenadores da atenção básica.


The goal of the research was identify the organization of oral health care services, in the context of health care networks, in the municipalities of the metropolitan region of Porto Alegre. This is a cross-sectional survey of descriptive character. A census was held between oral health teams who participated in the second cycle of the program to improve access to and quality of basic care. Regular performance was observed in the program, for supremacy of the buccal health teams. The municipality of Gravataí presented the best estimates of performance among the evaluated in the study. With this mapping can be concluded that the oral health care network in the metropolitan region of Porto Alegre is strengthened as the principles of the basic attention authorising officers.

14.
An Acad Bras Cienc ; 92(1): e20190458, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32401837

RESUMO

In this study, we evaluated the reproductive activity and the temporal and spatial distributions of anuran assemblages in three environments within a semideciduous forest in Southeast Brazil, located at Municipality of Barão de Monte Alto, State of Minas Gerais, Brazil. The field activities were carried out during three consecutive days, monthly throughout the rainy seasons of 2013-2014 and 2014-2015. We recorded 28 anurans species, distributed in eight families. We observed the spatial-temporal distribution of some species, and their associated reproductive behaviors through exploration of vocalizations at different sites. The spatial and temporal distribution of the species seems to adapt to abiotic and biotic factors of their environment.


Assuntos
Anuros/crescimento & desenvolvimento , Ecossistema , Distribuição Animal/fisiologia , Animais , Anuros/classificação , Brasil , Monitoramento Ambiental , Florestas , Dinâmica Populacional , Reprodução , Estações do Ano
15.
Arq. odontol ; 56: 1-8, jan.-dez. 2020. tab, graf
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-1120201

RESUMO

Objetivo: Avaliar a efetividade de uma abordagem de tratamento não invasiva para a inativação de lesões não cavitadas de dentes decíduos e permanentes realizada na Clínica Infanto-Juvenil (CIJ) da Faculdade de Odontologia da Universidade Federal do Rio Grande do Sul (FO-UFRGS), identificando os fatores clínicos do paciente e associando-os ao sucesso clínico do tratamento. Métodos: Foram incluídos 55 prontuários de pacientes que receberam instruções de higiene bucal, controle de dieta e aplicações tópicas de flúor (ATF) na CIJ da FO-UFRGS entre 2016 e 2018. Foram coletados dados demográficos e clínicos referentes a avaliação da atividade de cárie dentária na consulta inicial e após o tratamento realizado: índice de placa visível (IPV), índice de sangramento gengival (ISG) e o número médio de dentes permanentes cariados, perdidos e restaurados (CPO-D) e/ou número médio de dentes decíduos cariados, extraídos ou com indicação de extração e restaurados (ceo-d). Na análise estatística foram utilizados os testes Qui-quadrado de Pearson, Exato de Fisher e Wilcoxon, nível de significância: p < 0,05. Resultados: Não houve diferença estatisticamente significativa quando se comparou as variáveis idade, sexo, IPV, ISG e ceo-d/CPO-D com o sucesso do tratamento. Houve diferença estatisticamente significativa comparando o IPV inicial com o final (p = 0,016) e número de lesões não cavitadas ativas inicial e final (p < 0,001), mas não houve diferença para o ISG inicial e final (p = 0,324). Conclusão:Baseado nos achados da redução do IPV e da redução no número de lesões não cavitadas ativas ao final do tratamento, sugere-se que a abordagem de tratamento não invasiva para inativação de lesões de cárie dentária não cavitadas aplicada na CIJ da FO-UFRGS é efetiva.


Aim: To evaluate the effectiveness of a non-invasive treatment on the arrest of non-cavitated caries lesions of primary and permanent teeth performed at the Pediatric Clinic (PC) at the Dental Teaching Hospital of the Federal University of Rio Grande do Sul (DT-UFRGS), identifying the patient's clinical factors and associating them with the clinical success of the treatment. Methods: This study included 55 patient's medical records who received oral hygiene instructions, diet control, and topical fluoride applications (TFA) at the PC of DT-UFRGS between 2016 and 2018. Demographic and clinical data regarding the evaluation of caries activity in the initial visit and after the performed treatment were collected: visible plaque index (VPI), gingival bleeding index (GBI), and DMF-T caries index (average number of decayed, missing, and restored permanent teeth), and/or dmf-t (average number of decayed, extracted or with recommendation for extraction, and restored deciduous teeth). Pearson's Chi-square, Fisher's Exact, and Wilcoxon tests were used for statistical analysis, significance level: p < 0.05. Results: No significant difference was observed when the variables of age, gender, VPI, CBI, DMF-T/dmf-t were compared with treatment success. A statistically significant difference was found when comparing the initial with the final VPI (p = 0.016), as well as the number of initial and final active non-cavitated carious lesions (p < 0.001), but no difference was identified for the initial and final GBI (p = 0.324). Conclusion: Based on the findings of VPI reduction and reduction in the number of active non-cavitated carious lesions upon completion of treatment, it is suggested that the non-invasive treatment for arrestment of non-cavitated carious lesions applied at the PC of DT-UFRGS is effective.


Assuntos
Criança , Higiene Bucal , Dente Decíduo , Criança , Fluoretos Tópicos , Cárie Dentária , Flúor/uso terapêutico , Índice CPO , Análise Estatística , Estudos Retrospectivos
16.
Rev. bras. epidemiol ; 23: e200074, 2020. tab, graf
Artigo em Português | LILACS-Express | LILACS | ID: biblio-1126059

RESUMO

RESUMO: Objetivo: Barreiras à comunicação são principais dificultadores do acesso de pessoas com deficiência sensorial (visual e auditiva) aos serviços de saúde. Os objetivos do estudo foram analisar a prevalência e os fatores associados à presença de facilitadores à comunicação nas unidades básicas de saúde no Brasil. Métodos: Estudo transversal multinível sobre dados de 38.811 unidades de saúde de 5.543 municípios, entre 2012 e 2013, coletados no Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica (PMAQ-AB). Desfecho criado agrupando facilitadores à comunicação (material em relevo/braille; recurso auditivo; comunicação visual; listagem acessível de ações do serviço; profissional para acolhimento de usuário com deficiência sensorial). As variáveis de exposição do nível I (contextuais) foram: macrorregião, porte populacional e produto interno bruto (PIB) per capita. No nível II, (serviço) foram: equipe ampliada; modelo de atenção; turnos de atendimento; sala de acolhimento; divulgação do horário de atendimento; presença de facilitadores ao acesso físico. Utilizou-se regressão de Poisson multinível com modelagem hierárquica em dois estágios. Resultados: A presença dos facilitadores à comunicação é pequena nas unidades de saúde (32,1%), sendo mais frequentes nas unidades localizadas nos municípios com maior PIB (razão de prevalência - RP = 1,02, intervalo de confiança de 95% - IC95% 0,92 - 1,12) e porte populacional (RP = 1,25, IC95% 1,02 - 1,52). Conclusão: Ter profissional para acolhimento é o principal facilitador ao acesso e deve ser foco de ações para melhorar a atenção à saúde das pessoas com deficiência. Faz-se necessário promover acesso universal, com adequação de serviços, remoção de barreiras à comunicação e estímulo ao acolhimento do usuário.


ABSTRACT: Objective: Communication barriers are the main obstacle for people with sensory disabilities (visual and hearing) to access health services. This study aims to describe the presence of facilitators of communication of basic health units in Brazil and to verify its associated factors. Methods: Cross-sectional multilevel study, of 38,811 health units in 5,543 municipalities between 2012 and 2013, collected in the National Program for Improving Access and Quality in Primary Care (Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica - PMAQ-AB). The outcome was defined by grouping facilitators of communication (braille material; hearing resources; visual communication; accessible list of service; professionals to welcome users with sensory disabilities). The two levels were structured, using the variables: level I (contextual): macro region, population size, and GDP per capita; and level II (service): extended professional team (psychologist/social worker); service shifts; welcoming room; publishing of service hours; presence of physical access facilitators. Multilevel Poisson regression with hierarchical modeling was used in both stages. Results: The presence of facilitators of communication is small in Brazilian health units (32.1%). It is more frequent in the municipalities with a higher GDP (RP = 1.02, 95%CI 0.92 - 1.12) and population size (RP = 1.25, 95%CI 1.02 - 1.52). Conclusion: Welcoming users is the main access facilitator and should be the focus of initiatives to improve health care for disabled persons. Universal access with adequate services, removal of communication barriers and encouragement to properly welcome users must be promoted.

17.
Rev. bras. med. trab ; 17(2): 201-208, ago.2019.
Artigo em Português | LILACS-Express | LILACS | ID: biblio-1015201

RESUMO

Introdução: Os acidentes de trabalho são o maior agravo à saúde dos trabalhadores, tornando-se, assim, um importante problema de saúde pública. Objetivo: O presente estudo teve como objetivo identificar o perfil epidemiológico dos profissionais da saúde que sofreram acidentes de trabalho com material biológico no ano de 2017 no município de Canoas, Rio Grande do Sul. Método: Trata-se de um estudo transversal descritivo baseado nas fichas de notificações de acidentes de trabalho com exposição a material biológico, contidas na base de dados da vigilância epidemiológica da secretaria municipal de saúde de Canoas. Resultados: No ano de 2017 ocorreram 121 casos de acidente de trabalho com exposição a material biológico. Houve predomínio de acidentes em mulheres (93,4%), da raça branca (69,4%), na faixa etária de 20 a 30 anos (40,5%). Em relação ao tipo de exposição, as percutâneas correspondem a 76,8% dos casos, sendo o sangue o material orgânico mais prevalente (90%) e a agulha com lúmen, o principal agente causador (64,5%). A luva foi o equipamento de proteção individual mais utilizado (75,2%), e os trabalhadores estavam vacinados em 93,4% dos casos. Conclusão: Há a necessidade de reciclagem de hábitos profissionais consolidados pela prática diária, incluindo treinamento sobre o uso correto de equipamentos de proteção individual e adoção de precauções em todas as etapas da assistência


Background: Work accidents pose the most risk to the health of workers and thus represent a considerable public health problem. Objective: To establish the epidemiological profile of healthcare workers who were victims of accidents involving biological materials in Canoas, Rio Grande do Sul, Brazil, in 2017. Methods: Cross-sectional descriptive study based on reports of work accidents involving exposure to biological materials included in the epidemiological surveillance database of the Municipal Secretariat of Health of Canoas. Results: 121 work accidents involving exposure to biological materials occurred in 2017. Accidents prevailed among females (93.4%), whites (69.4%) and workers aged 20 to 30 years old (40.5%). Percutaneous exposure was associated with 76.8% of accidents, blood was the most prevalent biological material involved (90%) and hollow needles the main causative agent (64.5%). Gloves were the most frequently worn piece of personal protective equipment (PPE) (75.2%). About 93.4% of the sample was vaccinated against hepatitis B. Conclusion: Habits long consolidated in daily practice need to be reviewed, including training on correct use of PPE and adoption of precautions in all stages of care delivery

18.
Oral Health Prev Dent ; 17(3): 211-218, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31209443

RESUMO

PURPOSE: This study aimed to elicit willingness to pay (WTP) values for fluoride varnish application from participants using the publically-funded health services in Brazil and the UK, and to identify differences in the variables impacting these values. A secondary aim was to compare WTP values from parents for their own preventive treatment and their child's. MATERIALS AND METHODS: This was a cross-sectional analysis of quantitative data collected from participants attending routine dental appointments. The clinics were hosted by the Pontifical Catholic University of Rio Grande do Sul (PUCRS), Brazil and Newcastle Dental Hospital, UK. RESULTS: The mean WTP for Brazilian adults was R$60.37 (=£15.97). WTP was highly variable and factors affecting it were difficult to identify. UK parents valued fluoride varnish at mean values of £28.21 and £28.12 for themselves and their child, respectively. Regression modelling found those with higher incomes had higher WTP in both samples. In the UK, parental and child WTP increased when parents had higher self-perceived need for dental treatment, had experienced recent dental pain, or their child had received restorations in the last 2 years. CONCLUSIONS: WTP for fluoride varnish varied dramatically between individuals. In both countries, it was difficult to predict this variance, as factors which would likely impact upon on WTP had a limited effect and were sometimes counter-intuitive. WTP values for a parent and their child were not statistically significantly different.


Assuntos
Fluoretos , Pais , Adulto , Brasil , Criança , Estudos Transversais , Assistência Odontológica , Humanos
19.
Cien Saude Colet ; 24(5): 1809-1820, 2019 May 30.
Artigo em Português | MEDLINE | ID: mdl-31166514

RESUMO

Ensuring access to dental care services requires the development of healthsurveillance practices to ensure comprehensive health care. The objective of this study was toinvestigate the association between social and economic indicators of Brazilian municipalities, work process characteristics, and performance of a list of curative dental procedures by oral health teams. It involved an exploratory, cross-sectional study withmulticenter data collection from 11,374 oral health teams assessed by the National Program for Improvement of Access to and Quality of Primary Healthcare. Multilevel Poisson regression was used to obtain the prevalence of curative dental procedures, which was 69.51%. The social/economic and work variables that remained associated with the outcome included municipalities in which the proportion of primary care-sensitive admissions was below 28% and that of tooth extractions below 8%; and oral health teams classified as type II (including oral health assistant and technician) that had different materials available and better work processes. This multilevel analysis, which took into consideration the performance of curative dental care in Brazil, reveals a worrying oral healthcare scenario.


Assuntos
Assistência Odontológica/organização & administração , Serviços de Saúde Bucal/organização & administração , Equipe de Assistência ao Paciente/organização & administração , Atenção Primária à Saúde/organização & administração , Brasil , Assistência Integral à Saúde/organização & administração , Estudos Transversais , Serviços de Saúde Bucal/normas , Acesso aos Serviços de Saúde , Humanos , Programas Nacionais de Saúde/organização & administração , Saúde Bucal , Atenção Primária à Saúde/normas , Qualidade da Assistência à Saúde
20.
Ciênc. Saúde Colet ; 24(5): 1809-1820, Mai. 2019. tab, graf
Artigo em Português | LILACS | ID: biblio-1001784

RESUMO

Resumo A garantia de atenção odontológica passa pelo desenvolvimento de práticas pautadas na vigilância em saúde, a fim de concretizar a integralidade. Objetivou-se avaliar a associação entre aspectos contextuais dos municípios brasileiros, características do processo de trabalho e a realização de um rol de procedimentos odontológicos curativos pelas equipes de saúde bucal (ESB). Trata-se de estudo exploratório transversal cuja coleta multicêntrica de dados se deu em 11.374 ESB avaliadas pelo Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica. Foi empregada regressão de Poisson multinível para obtenção da prevalência de realização de procedimentos odontológicos curativos, que foi de 69,51%. As variáveis contextuais e da equipe de saúde que se mantiveram associadas ao desfecho incluíram municípios cuja proporção de internações sensíveis à atenção básica foi menor que 28% e cuja proporção de exodontias foi menor que 8%; bem como ESB de modalidade II que tinham à disposição materiais, insumos e melhores processos de trabalho. Esta análise multinível, que considera o desempenho da atenção odontológica curativa no Brasil, aponta para um cenário de atenção odontológica preocupante.


Abstract Ensuring access to dental care services requires the development of healthsurveillance practices to ensure comprehensive health care. The objective of this study was toinvestigate the association between social and economic indicators of Brazilian municipalities, work process characteristics, and performance of a list of curative dental procedures by oral health teams. It involved an exploratory, cross-sectional study withmulticenter data collection from 11,374 oral health teams assessed by the National Program for Improvement of Access to and Quality of Primary Healthcare. Multilevel Poisson regression was used to obtain the prevalence of curative dental procedures, which was 69.51%. The social/economic and work variables that remained associated with the outcome included municipalities in which the proportion of primary care-sensitive admissions was below 28% and that of tooth extractions below 8%; and oral health teams classified as type II (including oral health assistant and technician) that had different materials available and better work processes. This multilevel analysis, which took into consideration the performance of curative dental care in Brazil, reveals a worrying oral healthcare scenario.


Assuntos
Humanos , Equipe de Assistência ao Paciente/organização & administração , Atenção Primária à Saúde/organização & administração , Assistência Odontológica/organização & administração , Serviços de Saúde Bucal/organização & administração , Atenção Primária à Saúde/normas , Qualidade da Assistência à Saúde , Brasil , Saúde Bucal , Estudos Transversais , Assistência Integral à Saúde/organização & administração , Serviços de Saúde Bucal/normas , Acesso aos Serviços de Saúde , Programas Nacionais de Saúde/organização & administração
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