A glimpse into the curricular format of comprehensive care clinics in Brazilian dental schools.

OBJECTIVE: This study aimed to describe some curricular aspects of comprehensive dental care clinics in Brazil. MATERIALS AND METHODS: An email survey was sent to all academic affairs deans of Brazilian undergraduate dental programmes. It contained questions regarding the (1) curricular format and (2) characteristics of comprehensive dental care clinics. RESULTS: Sixty-seven dental schools agreed to participate. It was observed that curricular changes have contributed to modify the structure of these clinics in 88.1% of the schools surveyed. The main alteration was related to an increase in credit hours and offer of this type of care at different levels of the dental curriculum. In 95.5% of the schools, clinical procedures were prioritized according to level of complexity. Inter-disciplinarity (37.3%) and teaching innovation (58.2%) were frequent challenges in the process of change. Progress in combining teaching and clinical services was reported by 50.8% of schools. In 32.8%, clinical procedures were still being performed intra-murally. CONCLUSIONS: Changes in the curriculum of Brazilian comprehensive dental care clinics were observed by this survey.

[The meanings that postpartum women assign to gestational hypertension and premature birth]. / Significados atribuídos por puérperas às síndromes hipertensivas da gravidez e nascimento prematuro.

The objective of this study was to understand the meanings that postpartum women assign to gestational hypertension that resulted in premature birth. Participants were 70 women, with a mean age of 28 years, 85.7% of whom delivered between the 32nd and 36th gestational week. A questionnaire with subjective questions was applied to identify the meanings of gestational hypertension and premature delivery for postpartum women. Results were analyzed based on the Theory of Social Representations. We observed the construction of a negative social representation, with death as the central nucleus and negative aspects as the peripheral nuclei. The latter derive from the risks the mother and fetus were exposed to during pregnancy and later in the postpartum period with the hospitalization of the child in the neonatal intensive care unit.

Composition of the Health Inequality Index analyzed from the inequalities in mortality and socioeconomic conditions in a Brazilian state capital. / Composição do Índice de Iniquidade em Saúde a partir das desigualdades na mortalidade e nas condições socioeconômicas em uma capital brasileira.

The issue of social inequalities is a subject of recurrent studies and remains relevant due to the growing trend of these inequalities over the years. This study proposes the creation of the Health Inequality Index (HII) composed of health indicators - Mean life span and Mean Potential Years of Life Lost (PYLL) - and socioeconomic indicators of income, schooling, and population living in poverty in the city of Natal - the State Capital of Rio Grande do Norte, Brazil. Therefore, a probabilistic linkage was made between mortality and socioeconomic databases in order to capture the census tracts of households with death records from 2007 to 2013. The authors used the Principal Component Factor Analysis to calculate the index. The Health Inequality Index showed areas with worse socioeconomic and health conditions located in the suburban areas of the city, with differences between and within the districts. The difference in the mean life span between the districts of Natal arrives at 25 years, and the worst district has mortality rates comparable to poor African countries. Public policymakers can use the index to prioritize actions aimed at reducing or eliminating health inequalities.

[Social representation of fathers regarding their premature child in the Neonatal Intensive Care Unit]. / Representação social de pais sobre o filho prematuro na Unidade de Terapia Intensiva Neonatal.

Qualitative study that aimed at understanding the social representation of a parent with a premature child. The data were collected between May and June 2008, in a semi-structured interview with 17 parents whose premature children were hospitalized in the NICU of two public institutions in Natal, Brazil. The reports were analyzed based on the Social Representations Theory (SRT). The results reveal that the hospitalization of their children causes parents to experience emotions of fear, anguish, anxiety, loneliness interspersed with those of faith, joy and hope. For a parent the NICU is a frightening environment, albeit necessary for the specialized care that the conditions of the premature newborn require.

[Representations of mothers about the hospitalization of their premature child]. / Representações de mães sobre hospitalização do filho prematuro.

Qualitative study aimed at knowing the representations of mothers about the hospitalization of their premature son in a Neonatal Intensive Care Unit (NICU). The sample was composed of eighteen mothers of premature newborns hospitalized in a school hospital in Natal, Brazil. A semi-structured interview was used and data analysis showed that hospitalization of a child is represented by the mothers as meanings, feelings, difficulties and uncertainties. It is considered that prematurity represents a maternal challenge from the moment of the premature birth, proceeding with disturbances inherent to hospitalization. These require awareness, listening and dialogue on the part of health professionals in an effective manner in order to strengthen maternal adaptation to prematurity.

O ensino do amálgama na formação odontológica ainda é necessário? Percepção de cirurgiões-dentistas / ¿Sigue siendo necesaria la enseñanza de la amalgama en la carrera odontológica? Percepción de los dentistas / Is the teaching of amalgam in dental training still necessary? Perceptions of dentists

A Odontologia tem vivenciado, nos últimos tempos, um declínio acentuado do uso do amálgama, em consequência da evolução dos materiais e técnicas adesivas e das discussões acerca dos riscos de contaminação pelo mercúrio. Assim, buscou-se identificar a percepção dos cirurgiões-dentistas sobre a necessidade da continuidade do ensino do amálgama nos cursos de Odontologia. Trata-se de um estudo transversal, usando um questionário semiestruturado com aspectos relativos às condições sociodemográficas, capacitação para executar os procedimentos, conhecimento acerca do manejo do material e gerenciamento dos resíduos. As respostas objetivas foram analisadas pela estatística descritiva e as subjetivas processadas no software IRaMuTeQ. Dos 257 respondentes, 60,7%afirmam utilizar esse material, 91,8% usam amálgama encapsulado e 95,7% descartam os resíduos em lixo hospitalar. Sobre a permanência do material, 63,4% acreditam ser necessária e 88% concordam que o ensino deva continuar sobretudo considerando o perfil do egresso sugerido pelas Diretrizes Curriculares Nacionais. Dos dados subjetivos emergiram cinco classes/categorias que retratam a percepção dos profissionais sobre relação custo-benefício, acesso ao serviço, condições de trabalho e longevidade das restaurações. Conclui-se que, mesmo com a evolução dos materiais adesivos, o amálgama ainda é necessário, principalmente no serviço público, onde a demanda por restaurações de baixo custo e grande longevidade é alta. Assim, para essa amostra, enquanto não houver um material restaurador livre de mercúrio, barato, de fácil manuseio e durável, o ensino desse conteúdo deve permanecer nos cursos de graduação em Odontologia (AU).

La odontología ha experimentado recientemente una fuerte disminución en el uso de amalgamas como resultado de las discusiones sobre los riesgos de contaminación por mercurio, así como la evolución de los materiales y las técnicas adhesivas. Así, buscamos identificar la percepción de los odontólogos sobre la necesidad de continuar enseñando amalgama en los cursos de odontología. Se trata de un estudio transversal utilizando un cuestionario semiestructurado con aspectos relacionados con las condiciones sociodemográficas, capacitación para realizar los procedimientos, conocimientos sobre manejo de materiales y gestión de residuos. Las respuestas objetivas se analizaron mediante estadística descriptiva y las respuestas subjetivas se procesaron mediante el software IRaMuTeQ. De los 257 encuestados, el 60,7% afirma utilizar este material, el 91,8% utiliza amalgama encapsulada y el 95,7% desecha los residuos en la basura de hospital. En cuanto a la permanencia del material, el 63,4% cree que es necesario y el 88% está de acuerdo en que la enseñanza debe continuar, sobre todo para la graduación de profesionales que van al servicio público. A partir de los datos subjetivos, surgieron cinco clases/categorías que retratan la percepción de los profesionales sobre la rentabilidad, el acceso al servicio, las condiciones de trabajo y la longevidad de las restauraciones. Se concluye que, aún con la evolución de los materiales adhesivos, la amalgama sigue siendo necesaria, especialmente en el servicio público, donde la demanda de restauraciones de bajo costo y gran longevidad es alta. Así, mientras no exista un material restaurador libre de mercurio, económico, fácil de manejar y duradero, la enseñanza de este contenido O ensino do amálgama na formação odontológica ainda é necessário? Percepção de cirurgiões-dentistas debe permanecer en los cursos de graduación en odontología (AU).

Dentistry has recently experienced a sharp decline in the use of amalgam, as a result of the evolution of adhesive materials and techniques and discussions about the risks of mercury contamination. Thus, we sought to identify the perception of dentists about the need to continue teaching amalgam in dentistry courses. This is a cross-sectional study, using a semi-structured questionnaire with aspects related to sociodemographic conditions, training to perform the procedures, knowledge about material management and waste management. The objective responses were analyzed by descriptive statistics and the subjective ones processed in the IRaMuTeQ software. Of the 257 respondents, 60.7% claim to use this material, 91.8% use encapsulated amalgam and 95.7% dispose of waste in hospital waste. Regarding the permanence of the material, 63.4% believe it is necessary and 88% agree that teaching should continue, especially considering the profile of the graduate suggested by the National Curriculum Guidelines. From the subjective data emerged five classes/categories that portray the perception of professionals about cost-benefit ratio, access to service, working conditions and longevity of restorations. It is concluded that, even with the evolution of adhesive materials, amalgam is still necessary, especially in the public service, where the demand for low cost and high longevity restorations is high. Thus, for this sample, as long as there is no mercury-free, inexpensive, easy to handle and durable restorative material, the teaching of this content should remain in undergraduate courses in Dentistry (AU).

[Cultural aspects in the understanding of chronic periodontitis: a qualitative study]. / Aspectos culturais na compreensão da periodontite crônica: um estudo qualitativo.

This study aimed to analyze the concepts, beliefs, attitudes, and explanatory models related to chronic periodontitis among individuals with this disease in order to facilitate communications between dentists and patients and foster conscientious treatment adherence. The study sample consisted of 20 patients from the Periodontics Specialization Courses at Fortaleza University and the Brazilian Dental Association in Fortaleza, Ceará State. Data were gathered from October 2004 to January 2005. A qualitative methodological framework was used to interpret the patients' subjective expression. Semi-structured interviews were applied to obtain patients' accounts of their individual experience with the disease condition. Thematic discourse analysis used: empirical categories established within the study itself, simple frequencies and calculated percentages, and refinement of thematic classifications. According to their reports, patients understand the periodontal heath-disease process through the intermediation of both popular and scientific knowledge, involvement of living and work conditions, and access to quality care, i.e., they do not incorporate only the biomedical discourse.

Curcuma longa extract protects against 5-fluorouracil-induced oral mucositis in hamsters

Abstract Curcumin, contained at Turmeric (Curcumalonga), can exert many beneficial pleiotropic activities in the gastrointestinal tract. This study evaluated the antioxidant and anti-inflammatory activity of C. longa on 5-fluorouracil (5-FU)-induced oral mucositis (OM) in hamsters. Phytochemical analysis of crude C. longa extract (CLE) was performed to detect the presence of curcumin by TLC and HPLC. Golden Syrian hamsters were orally pre-treated with CLE (5, 50, or 100mg/kg). Cheek pouch samples were subjected to macroscopic and histopathological evaluation. ELISA was performed to quantify the inflammatory cytokines IL-1ß and TNF-α. Superoxide dismutase (SOD), glutathione (GSH) and malondialdehyde (MDA) levels were assessed by ultraviolet-visible spectroscopy analysis. Behavior analysis was conducted by the open field test. Curcumin content in the CLE was 0.55%m/m ± 0.0161 (2.84%). The group treated with 5mg/kg CLE showed healing evidence with macroscopic absence of ulceration (p<0.05) and microscopic aspect of re-epithelialization, discrete inflammatory infiltrate and absence of edema. Treatment with 5mg/kg CLE significantly increased GSH levels, and reduced MDA levels and SOD activity (p˂0.05), and decreased IL-1ß (p˂0.05) and TNF-α (p˂0.01) levels. A significant reduction in walking distance, ambulation, speed, and rearing was observed for motor activity. Curcumin reduced oxidative stress, inflammation, and motor activity in hamsters with 5-FU-induced OM.

[Regional inequalities in cervical cancer mortality in Brazil: trends and projections through to 2030]. / Desigualdades regionais na mortalidade por câncer de colo de útero no Brasil: tendências e projeções até o ano 2030.

The scope of this article is to analyze the temporal trends of cervical cancer mortality in Brazil and calculate the projection of mortality through to the year 2030. Deaths that occurred within the 1996-2010 period were analyzed (Mortality Information System). Mortality trend analysis utilized the Joinpoint regression, while Nordpred was utilized for the calculation of projections. For Brazil, decreasing trends were identified (APC = 1.7% CI95%-2.2; -1.1 p < 0.05). The Midwest region presented a significant reduction trend (APC = -1.3% per year), along with the Southeast (APC = -3.3%) and South (APC = -3.9%) regions. The North and Northeast regions presented stable trends. The states of Acre (APC = -6.5%) and Rio Grande do Sul (APC = -4.1%) presented the most pronounced reduction trends. Analysis of the mortality projections revealed a reduction in mortality rates, starting from the first projected period, with a considerable reduction for the South region. Mortality rates through to the year 2030 are explained, principally, by reductions in the risk of the disease. Cervical cancer mortality presents reducing trends, however these are unequally distributed throughout the country, where the North and Northeast regions present the highest mortality rates.

Aspectos ético-legais que envolvem a manipulação de dentes humanos extraídos: o olhar de cirurgiões-dentistas / Ethical and legal aspects involving the manipulation of extracted human teeth: the dental surgeons' viewpoint

Investigou-se o conhecimento de cirurgiões-dentistas acerca dos aspectos ético-legais envolvidos na manipulação e descarte de elementos dentários humanos extraídos. Utilizou-se um questionário semiestruturado, enviado eletronicamente para cirurgiões-dentistas. Asperguntas objetivas foram analisadas pela estatística descritiva e as subjetivas peloDiscurso do Sujeito Coletivo. Dos 208 cirurgiões-dentistasrespondentes, 78,4% reconheceram o elemento dentário como órgão, 98,6% afirmaram ter utilizadodentes humanos para treinamento laboratoriale pesquisa na graduaçãoe pós-graduação, 42,4% obtiveramesses dentesem unidades de saúde, 28,3% em consultórios odontológicos, 22% na instituição de ensino e 2,4% através de compra. Sinalizou-se a doação por unidades de saúdee consultórios odontológicos como forma ideal para aquisição dos dentes (72,11%). Apesar de 75,5% afirmarem conhecer a regulamentação específica, issonão se refletiu nas demais questõesavaliadas. Quanto ao risco biológico na manipulação dos dentes, 88,9% consideraram existir e a análise qualitativa das respostas gerou as categorias "contaminação" e "infecção cruzada". Já sobre a finalidade do Banco de Dentes, 59,6% declararam conhecê-las, emergindo categorias como "ensino e pesquisa" e "comércio ilegal". A despeito desse conhecimento, apenas 43,3% indicaram estar totalmente dispostos a se vinculara um Banco de Dentes para doação.Conclui-se que existe pouco conhecimento quanto aos aspectos ético-legais envolvidos na manipulaçãoe descarte de dentes humanos extraídose que essa insciência se reflete na baixa intenção em se vincular às atividades de um futuro Banco de Dentes instalado no município pesquisado (AU).

It was intended to investigate the knowledge of dental surgeons about the ethical and legal aspects involved in the handling and disposal of extracted human teeth. A semi-structured questionnaire was used, sent electronically to dental surgeons. The objective questions were analyzed by descriptive statistics and the subjective ones by Collective Subject Discourse. Of the 208 dental surgeons who answered the questionnaire, 78.4% recognized the dental element as an organ, 98.6% stated that they used human teeth for laboratory training and research during graduation and post-graduation, 42.4% obtained these teeth in health units, 28.3% in dental offices, 22% in teaching institution and 2.4% through purchase. Donation by health units and dental offices was signaled as the ideal way to acquire the teeth (72.11%). Although 75.5% claimed to know the specific regulation, this was not reflected in the other questions evaluated. As for the biological risk in handling teeth, 88.9% considered it existed and the qualitative analysis of the answers generated the categories "contamination" and "cross infection". As for the purpose of the Tooth Bank, 59.6% said they knew it, and categories such as "teaching and research" and "illegal trade" emerged. Despite this knowledge, only 43.3% indicated that they were totally willing to join a tooth bank for donation. It is concluded that there is little knowledge about the ethical-legal aspects involvedin the handling and disposal of extracted human teeth and that this unawareness is reflected in the low intention of joining the activities of a future Tooth Bank installed in the researched municipality (AU).

[Outside clinical setting experience in a public hospital and oral health promotion]. / Experiência extramural em hospital público e a promoção da saúde bucal coletiva.

OBJECTIVE: To describe a teaching aid activity aimed at providing experience for promoting collective oral health to graduating dental students. METHODS: This experience was based on the evaluation of students' performance as oral health educators as they had, among other duties, to motivate inpatients and their families to practice healthy habits aiming at a comprehensive and more human care of hospitalized patients. RESULTS: The results show that oral hygiene was incorporated into hospital routine, evidenced by the differences between baseline and final dental biofilm indices (1.72 and 1.17, respectively). Using the U-Mann-Whitney test, this difference was extremely significant (p<0.001) and reveals that mother-child were highly motivated with respect to oral hygiene. CONCLUSIONS: It is concluded that teaching-learning experiences derived from interdisciplinary and interdisciplinary activities have allowed for a better understanding of the health-disease process by dental students. It is also an opportunity for learning about planning and implementing education-prevention activities, which complement these students' technical-professional experience and promotes social sensitivity, which is essential to professional training.

[Social representation and hospital occupational risk]. / Representação social sobre o risco ocupacional hospitalar.

PURPOSE: To apprehend the central and periphery elements on the occupational risk and the level of satisfaction with the work, emitted by workers of an academic public hospital. METHODS: The sample was constituted by 84 different graduate health professionals who work for the hospital. The data collection was based on the following instruments: the free evocation from the "occupational" risk, an interview semi-structured aiming to capture socio-demographic data and the level of satisfaction of the work developed within the hospital environment, as well as the participant observation. For the analysis of the socio-demographic, it was used the descriptive statistical treatment based on the software Evoc 2000, as well as the Analysis of Content, according to Bardin (1977). These analysis aimed to capture the registrations obtained from the interviews as well as daily notes to verify the possible contradictions and consensus on the professional postures during their work shift. In addition, the analysis were also based on the Theory of the Social Representations and the Theory of the Central Nucleus. RESULTS: The results have demonstrated that the average age of the group is around 38,4 years old; (72.6%) of the work force with a graduate degree is female; 51% of the professionals interviewed work in other places besides the hospital; 83% are considered to be satisfied and only 17% are considered to be unsatisfied with the work accomplished in the hospital. Regarding to the occupational risk, some specific aspects were mentioned as the following categorization: risks of physical nature, chemistry, organic, mechanic, physiologic and psychic. Regarding to the content analysis, the following categories emerged: love to the profession; convenience and professional growth; reflection and critic. Based on the direct observation it was verified that it is common the noncompliance of the relative universal norms regarding to the use of protection equipments during the work. CONCLUSION: The organic occupational risks constituted the central nucleus of the representation of the workers in the hospital. It was observed that physiologic, mechanics and chemical risks are considered as periphery elements of that representation. In that perspective, it was suggested that some subjective aspects related to the organizational culture, in terms of control and elimination of the environmental risks, administration, process, organization and difficulties of the work should be taken into consideration when in the implementation of the intervention measures related to the workers' health.

Composição do Índice de Iniquidade em Saúde a partir das desigualdades na mortalidade e nas condições socioeconômicas em uma capital brasileira / Composition of the Health Inequality Index analyzed from the inequalities in mortality and socioeconomic conditions in a Brazilian state capital

Resumo O tema das desigualdades sociais é objeto de estudo recorrente e se mantem relevante pela ampliação delas ao longo dos anos. Este estudo propõe a criação do Índice de Iniquidade em Saúde (IIS), composto por indicadores de saúde - a Média de anos vividos e a Média de anos potenciais de vida perdidos (APVP) - e indicadores socioeconômicos de renda, escolaridade e população em condições de pobreza para a capital do estado do Rio Grande do Norte, Brasil. Foi realizado um linkage probabilístico entre os bancos de dados de mortalidade e socioeconômicos para captar os setores censitários das residências com registro de óbitos entre 2007-2013. Para o cálculo do índice foi utilizada a análise fatorial por componentes principais. O IIS apresentou áreas com piores condições socioeconômicas e de saúde localizadas perifericamente na cidade, com diferenças entre e dentro dos bairros. A diferença na média dos anos vividos entre os bairros de Natal chega a 25 anos, sendo que o pior bairro apresenta mortalidade comparável aos países mais pobres da África. Os formuladores de políticas públicas podem utilizar o índice na priorização de ações que visem à redução ou eliminação das iniquidades em saúde.

Abstract The issue of social inequalities is a subject of recurrent studies and remains relevant due to the growing trend of these inequalities over the years. This study proposes the creation of the Health Inequality Index (HII) composed of health indicators - Mean life span and Mean Potential Years of Life Lost (PYLL) - and socioeconomic indicators of income, schooling, and population living in poverty in the city of Natal - the State Capital of Rio Grande do Norte, Brazil. Therefore, a probabilistic linkage was made between mortality and socioeconomic databases in order to capture the census tracts of households with death records from 2007 to 2013. The authors used the Principal Component Factor Analysis to calculate the index. The Health Inequality Index showed areas with worse socioeconomic and health conditions located in the suburban areas of the city, with differences between and within the districts. The difference in the mean life span between the districts of Natal arrives at 25 years, and the worst district has mortality rates comparable to poor African countries. Public policymakers can use the index to prioritize actions aimed at reducing or eliminating health inequalities.

Transtornos alimentares e manifestações orais em adolescentes / Eating disorders and oral manifestations in adolescents / Trastornos alimenticios y manifestaciones orales en adolescentes

Introdução:Os transtornos alimentares são distúrbios psiquiátricos debilitantes, caracterizados por desordem persistente nos hábitos alimentares ou nos comportamentos docontrole de massa corporal.Objetivo:Avaliar, dentre adolescentes de três escolas públicas de ensino médio em Natal-RN, a prevalência dos transtornos alimentares e descrevermanifestações odontológicas relacionadas.Metodologia:Estudo realizado em duas fases, utilizando-seum questionário autoaplicável,Body Shape Questionnaire-BSQpara selecionara amostra. Os selecionados foram submetidos a uma avaliação partindoda história médica pregressa e exame clinico odontológico, paradiagnosticar as manifestações orais presentes. Resultados:Fase 1: Dos 231 alunos que responderam o questionário, 9 foram selecionados. No exame clínico observou-seque 22,2% dos avaliados apresentavam perda inicial da textura da superfície dentária na face palatina do segundo sextante, em 77,7% constatou-se hipertrofia da glândula parótida, 66,6% obtiveram escore 2 no Registro Periodontal Simplificado (PSR) e 11,1% dos examinadostinhaqueilite angular. Na fase 2: Dos 264 estudantes que responderam ao BSQ, 29estavamabaixo dopeso,164jovens apresentavam peso ideal, 24 peso muito abaixo do normal, enquanto a situação de sobrepeso foi observada em 47 estudantes. Quanto aoquestionário 25 (9%)apresentaram algum grau de distúrbio de distorção de imagem corporal, dentre os quais 80% do sexo feminino e 20% do sexo masculino. Conclusões:Foram encontradosepisódios de regurgitação associados a má nutrição e incorreta higienização da cavidade oral que favoreceuo aparecimento de alterações bucais.As principais manifestações encontradas foram: erosão dentária (22,2%), hipertrofia das glândulas salivares parótidas (77,7%), escore 2 no Registro Periodontal Simplificado-PSR (66,6%) e queilite angular (11,1%).É fundamental instrumentalizar ocirurgião-dentista a reconhecer tais manifestações,atrabalhar comabordagem multidisciplinar visando a melhoria da qualidade de vida do jovem, tratando assequelas e ajudando-o a superar suas necessidades.A maiorlimitação do estudo foi o encaminhamento desses jovens para tratamento (AU).

Introduction: Eating disorders are debilitating psychiatric disorders characterized by persistent disorder in eating habits or body mass control behaviors. Objective: To evaluate, among adolescents from three public high schools in Natal-RN, the prevalence of eating disorders and describe related dental manifestations.Methodology: Two-phasestudy using a self-administered Body Shape Questionnaire-BSQ to select the sample. Those selected were submitted to an evaluation based on previous medical history and dental examination to diagnose the oral manifestations present. Results: Phase 1: Of the 231 students who answered the questionnaire, 9 were selected. In the clinical examination it was observed that 22.2% of the subjects had initial loss of tooth surface texture on the palate of the second sextant, 77.7% had parotid gland hypertrophy, 66.6%had score 2 in the Registry. Periodontal Disease (PSR) and 11.1% of those examined had angular cheilitis. In phase 2: Of the 264 students who responded to the BSQ, 29 were underweight, 164 young people were underweight, 24 underweight, while overweight was observed in 47 students. Regarding the questionnaire 25 (9%) presented some degree of body image distortion disorder, among which 80% were female and 20% were male. Conclusions: Regurgitation episodes associated with poor nutrition and poor oral cavity hygiene were found, favoring the appearance of oral alterations. The main manifestations found were: dental erosion (22.2%), parotid salivary gland hypertrophy (77.7%), Simplified Periodontal Record (PSR) score 2 (66.6%) and angular cheilitis (11.1%). . It is essential to instruct the dentist to recognize such manifestations, to work with a multidisciplinary approach aimed at improving the quality of life of young people, treating the sequelae and helping them to overcome their needs. The major limitation of the study was the referral of these young people for treatment (AU).

Introducción:los trastornos alimentarios son trastornos psiquiátricos debilitantes caracterizados por un trastorno persistente en los hábitos alimentarios o en los comportamientos de control de la masa corporal. Objetivo:evaluar, entre los adolescentes de tres escuelas secundarias públicas de Natal-RN, la prevalencia de los trastornos alimentarios y describir las manifestaciones dentales relacionadas. Metodología:Estudio de dos fases utilizando un cuestionario de forma corporal autoadministrado-BSQ para seleccionar la muestra. Los seleccionados fueron sometidos a una evaluación basada en el historial médico previo y el examen dental para diagnosticar las manifestaciones orales presentes. Resultados: Fase 1: De los 231 estudiantes que respondieron el cuestionario, se seleccionaron 9. En el examen clínico se observó que el 22.2% de los sujetos tenían una pérdida inicial de la textura de la superficie dental en el paladar del segundo sextante, el 77.7% tenía hipertrofia de la glándula parótida, el 66.6% tenía una puntuación de 2 en el Registro. La enfermedad periodontal (PSR) y el 11,1% de los examinados tenían queilitis angular. En la fase 2: de los 264 estudiantes que respondieron al BSQ, 29 tenían bajo peso, 164 jóvenes tenían bajo peso, 24 tenían bajo peso, mientras que se observó sobrepeso en 47 estudiantes. En cuanto al cuestionario 25 (9%) presentó algún grado de trastorno de distorsión de la imagen corporal, entre los cuales el 80% eran mujeres y el 20% hombres. Conclusiones:se encontraron episodios de regurgitación asociados con una nutricióndeficiente y una mala higiene de la cavidad oral, lo que favorece la aparición de alteraciones orales. Las principales manifestaciones encontradas fueron: erosión dental (22.2%), hipertrofia de la glándula salival parótida (77.7%), puntaje 2 del registro periodontal simplificado (PSR) (66.6%) y queilitis angular (11.1%). . Es esencial instruir al dentista para que reconozca tales manifestaciones, para trabajar con un enfoque multidisciplinario dirigido a mejorar la calidad de vida de los jóvenes, tratar las secuelas y ayudarlos a superar sus necesidades. La principal limitación del estudio fue la derivación de estos jóvenes para recibir tratamiento (AU).

Alimentação saudável: a percepção de escolares sobre si próprios / Healthy eating, schoolchildren perception about themselves / Alimentación saludable: la percepción de escolares sobre sí mismos

RESUMO Objetivo Avaliar a percepção de escolares entre 7 a 10 anos de uma escola pública de Natal-RN sobre alimentação saudável. Método Estudo descritivo com abordagem quantitativa e qualitativa, mediante entrevista de grupo focal com 29 escolares com média de 8,8 anos de idade. A análise foi auxiliada pelo software IRAMUTEQ e apoiada no conceito de percepção de Merleau-Ponty. Resultados A percepção das crianças sobre alimentação saudável esteve associada aos alimentos in natura e preparações culinárias, identificando-se conceitos adquiridos na escola sobre o tema, além de professores criticando o consumo de alimentos ultraprocessados. Houve relatos de predileção por determinadas merendas da escola e rejeição de outras. As crianças citaram a presença de alimentos não saudáveis na merenda. Quanto ao papel da família foram citados pais orientando para o consumo saudável ao mesmo tempo em que estimulavam o consumo de alimentos industrializados em casa ou forneciam dinheiro para que os escolares os comprassem. Muitas crianças não consumiam alimentos saudáveis, sobretudo frutas e verduras por considerarem de sabor desagradável. Conclusão A percepção das crianças sobre alimentos saudáveis foi influenciada pela escola, família e mídia. Embora elas possuíssem noção do que seria uma alimentação saudável, o prazer conferido por alimentos industrializados conduzia a práticas não saudáveis. Os achados evidenciam a necessidade de um olhar ampliado pelos profissionais envolvidos nesse papel de estimular e direcionar para práticas saudáveis.(AU)

ABSTRACT Objective To evaluate the perception of schoolchildren between 7-10 years of a public school in Natal-RN about healthy eating. Method Descriptive study, with quantitative and qualitative approach by focus group interviews with 29 students whose average age was 8.8 years. The analysis was aided by IRAMUTEQ software and supported the concept of perception of Merleau-Ponty. Results Children's perception about healthy eating was associated with fresh foods and culinary preparations. We identified concepts acquired at school on the topic, as well as teachers criticizing the consumption of ultra-processed foods. There were reports of predilection for certain school meals and rejection of others. In addition, children have cited the presence of unhealthy foods served at school. Regarding the role of families, parents were cited in the role of guide for a healthy consumption at the same time they encouraged to consumption of processed foods at home or they provided money to buy them. Many children did not consume healthy foods, mainly fruits and vegetables because they consider unpalatable. Conclusion The perception of children about healthy foods was influenced by school, family and media. Although they possessed sense of what would be a healthy feed, the pleasure in eating processed foods led to unhealthy practices. The findings show the need for a look magnified by the professionals involved in this role to stimulate and drive healthy practices.(AU)

RESUMEN Objetivo Evaluar la percepción de escolares entre 7 y 10 años de una escuela pública de Natal-RN sobre alimentación saludable. Método Estudio descriptivo con enfoque cuantitativo y cualitativo, mediante entrevista de grupo focal con 29 escolares con una media de 8,8 años de edad. El análisis fue ayudado por el software IRAMUTEQ y apoyado en el concepto de percepción de Merleau-Ponty. Resultados La percepción de los niños sobre alimentación saludable estuvo asociada a los alimentos in natura y preparaciones culinarias, con las que identifican conceptos adquiridos en la escuela sobre el tema. Sus profesores criticaron el consumo de alimentos ultraprocesados. Hubo declaraciones sobre la predilección por ciertas meriendas de la escuela y rechazo hacia otras. Los niños citaron la presencia de alimentos no saludables en la merienda. En cuanto al papel de la familia, encontramos casos en los que padres de familia orientan a sus hijos hacia el consumo saludable, al mismo tiempo que estimulan el consumo de alimentos industrializados en casa o dando dinero para que los escolares los compren. Muchos niños no consumían alimentos saludables, sobre todo frutas y verduras, por considerarlas de sabor desagradable. Conclusión La percepción de los niños sobre los alimentos saludables estaba influenciada por la escuela, la familia y los medios de comunicación. Aunque eran conscientes de lo que sería una alimentación sana, el placer de los alimentos industrializados condujo a prácticas poco saludables. Los hallazgos evidencian la necesidad de una mirada ampliada por los profesionales involucrados en el papel de estimularlos y dirigirlos hacia prácticas saludables.(AU)

Social representations of mothers about gestational hypertension and premature birth.

OBJECTIVE: To identify the meanings attributed by mothers to hypertensive disorders of pregnancy (HDPs) and their consequences, such as premature birth and hospitalization of the infant in the neonatal intensive care unit (NICU). METHOD: A qualitative study, based on the Central Nucleus Theory, with 70 women who had hypertensive disorders of pregnancy and preterm delivery. We used the technique of free word association (FWAT) with three stimuli: high blood pressure during pregnancy, prematurity and NICU. RESULTS: We obtained 1007 evocations, distributed as follows: high blood pressure during pregnancy (335) prematurity (333) and NICU (339). These constituted three thematic units: representation of HDPs, prematurity and the NICU. The categories death and negative aspects were inherent to the three units analyzed, followed by coping strategies and needs for care present in HDPs and prematurity. CONCLUSION: The study had death as its central nucleus, and highlighted the subjective aspects present in the high risk pregnancy and postpartum cycle. It is hoped that this research will contribute to qualifying nursing care for women confronting the problem of HDPs, so that they can cope with less impacts from the adverse effects of high risk pregnancy and birth.

O conhecimento de deficientes visuais em relação à saúde bucal / The knowledge of the visually impaired about oral health

Introdução: A visão é uma das principais maneiras de interagir com o mundo. Em função desse déficit, os deficientes visuais desenvolvem mecanismo compensatório noutros sentidos como olfato, tato, audição e propriocepção. Objetivo: Investigar o nível de conhecimento em saúde bucal de 33 deficientes visuais matriculados no Instituto de Educação e Reabilitação de Cegos do Rio Grande do Norte (IERC-RN), conhecendo experiências que essas pessoas vivenciaram durante atendimento odontológico. Metodologia: Trata-se de estudo transversal, quanti-qualitativo usando entrevista. O material textual obtido pelas perguntas abertas gerou um corpus processado pelo Software IRAMUTEQ. Nesse contexto, o IRAMUTEQ categorizou o corpus através da classificação hierárquica descendente em seis classes distintas. Nas classes emergiram temas como acessibilidade, nervosismo e ansiedade no atendimento odontológico. A análise de similitude e a nuvem de palavras, também geradas pelo software possibilitaram perceber as principais expressões utilizadas, suas dificuldades, além de conexões com a saúde bucal e o ambiente odontológico. Resultados: As respostas das perguntas fechadas revelaram que a maioria dos entrevistados acredita que os dentes não duram para sempre, 90,09% escovam os dentes duas ou mais vezes por dia, utilizando principalmente escova e pasta, deixando o fio dental em segundo plano. Equívocos no conhecimento poderão ser superados pelo acesso a informação, criação de materiais educativos direcionados a essa clientela para enfrentamento das suas ansiedades e estímulo ao autocuidado. Conclusão: Paralelamente, a equipe de saúde bucal deve se preparar/capacitar para o atendimento desse segmento, pois pacientes com necessidades especiais exige habilidades diferenciadas, muita sensibilidade e conhecimento profissional adequado (AU).

Introduction: Eyesight is one of the main ways of interacting with the world. Due to this deficiency, visually impaired people develop compensatory mechanisms in other forms such as olfaction, tact, hearing and proprioception. Aim: This work investigated the level of knowledge in dental care from 33 visually impaired enrolled at Instituto de Educação e Reabilitação de Cegos do Rio Grande do Norte (IERC-RN) and understood experiences these people had during dental treatment. Methods: It is a transversal, quantitative-qualitative study that used interviews. The data collected from the open questions provided a corpus processed by IRAMUTEQ software. Thus, this software categorized the data through hierarchical classification descending on six separate classes. In the classes, questions such as accessibility, nervousness, and anxiety emerged. The analysis of similitude and the cloud of words, both generated by the software, made possible to perceive the main expressions used, difficulties, as well as the connections with dental care and the dental treatment office. Results: The answer to the closed questions revealed that most of the interviewees believe teeth do not last forever; 90% brush their teeth twice or more times a day using specifically a toothbrush and toothpaste; they use dental floss as a secondary procedure. Misconceptions might be surpassed by having them accessing information, creation of educational material directed to this clientele to face their anxieties and stimulating their self-dental care. Conclusion: Simultaneously, the dental care team must be prepared for the assistance to this clientele for patients with special needs demand different skills, much sensitiveness and adequate professional knowledge (AU).

Indicadores de qualidade na atenção primária à saúde no brasil: uma revisão integrativa / Quality indicators in primary health care in brazil: an integrating review

Objetivo: Apresentar a síntese dos indicadores de qualidade relacionados a resultados, com foco nas condições de saúde na atenção primária, presentes na literatura internacional e, a partir destes, descrever as intervenções ou estratégias utilizadas no Brasil para alcançar melhores resultados em saúde nos últimos anos. Métodos: Estudo de revisão integrativa dividido em duas etapas. Primeiro, foi realizada revisão da literatura, buscando identificar quais os indicadores relacionados a resultados utilizados para qualificar a atenção primária, sendo selecionados 6 estudos. Na segunda etapa, realizou-se revisão sistemática nas bases de dados MEDLINE, LILACS e CINAHL, na busca de artigos publicados no período de 2011 a 2017 que descrevessem intervenções realizadas no Brasil. Foram selecionados 25 artigos. Resultados: Compilou-se 18 domínios de indicadores de qualidade para atenção primária. Destes, 4 foram selecionados para a etapa posterior: diabetes mellitus, hipertensão arterial, imunização e/ou vacinação, e tabagismo e/ou alcoolismo. As intervenções ou estratégias estudadas foram, em sua maioria, direcionadas para promoção da saúde e prevenção de agravos, e mostraram resultados positivos de forma geral, utilizando educação em saúde, orientação farmacêutica e nutricional, recursos tecnológicos, entre outros. Conclusão: Os resultados apresentados fornecem suporte adicional para o monitoramento da qualidade da atenção primária no Brasil, ressaltando quais indicadores são internacionalmente reconhecidos como essenciais para melhoria da prestação do cuidado em saúde (AU).

Aim: To present a summary of quality indicators related to results, focusing on health conditions in primary care, found in the international literature and, from these, describe interventions or strategies used in Brazil to achieve better health outcomes in recent years. Methods: An integrative review study divided into two stages. First, a literature review was conducted in order to identify the indicators related to results used to describe primary care; six studies were selected. In the second stage, there was a systematic review in the MEDLINE, LILACS and CINAHL databases, searching for articles published in the period 2011 to 2017 describing interventions in Brazil. Twenty five articles were selected. Results: Eighteen domains of quality indicators for primary care were compiled. Of these, four were selected for the subsequent stage: diabetes mellitus, hypertension, immunization and / or vaccination, and smoking and / or alcoholism. The interventions or strategies studied were mostly directed at health promotion and disease prevention and, in general, showed positive results using health education, pharmaceutical and nutritional guidance, and technological resources, among others. Conclusion: The results presented herein provide additional support for monitoring the quality of primary care in Brazil, pointing out which indicators are internationally recognized as essential to improving the delivery of health care (AU).