Which factors influenced the adoption of interprofessionality in health based on the reports of the PET-Health Interprofessionality projects in Brazil? A document analysis.

The Program of Education through Work - Health (PET-Health) Interprofessionality is one of the strategic actions of the "Plan for the Strengthening of Interprofessionality" in healthcare in Brazil. Based on the experience of the program, this paperexamines the aspects that impact the adoption and strengthening of interprofessional education and collaborative practices, and issues recommendations for the strengthening of interprofessionality as a guiding principle of training and working in healthcare. This is a document analysis of partial reports from the six- and 12-months of execution of 120 PET-Health Interprofessionality projects in Brazil. The data were analyzed based on content analysis and the categories elaborated a priori. The aspects that impact the adoption and strengthening of interprofessionality in training and working in healthcare, and future recommendations, were organized in the relational, processual, organizational, and contextual dimensions, according to the framework by Reeves et al. The PET-Health Interprofessionality expanded the understanding of elements of interprofessional education and practice and showed that the discussion must take on a more political, critical, and reflexive character. The analysis points to the need for continuity of teaching-learning activities as a strategy to foster interprofessional capacity in healthcare services and consequent strengthening of the Unified Healthcare System in Brazil.

Dimensions of interprofessional collaboration in the dynamics of the expanded family health and primary care centers: A qualitative study.

Primary health care (PHC) in Brazil is based on Family Health Strategy (FHS) teams. These teams are supported by Expanded Family Health and Primary Care Centers (Nuclei) (NASF-AB) whose services are backbone elements for comprehensive health care within PHC. NASF-AB encompass several professional groups that aim to increase the responsiveness and scope of actions of the FHS teams. The objective of this study was to identify the dimensions of collaboration in the work dynamics of NASF-AB in the capital of Northeast Brazil. The study was a descriptive and exploratory research using a qualitative approach through semi-structured interviews with nine NASF-AB workers and three district health managers. Three analytical categories were identified following content analysis: "Interprofessional and inter-organizational collaboration," "Mainstays of collaboration in the relationship between NASF-AB and FHS," and "Challenges for a culture of collaboration in health care work." The results revealed important characteristics for interprofessional collaboration, including recognition of the attributions of the different teams and the key role of communication and planning. Participants highlighted roadblocks for interprofessional collaboration that hampered comprehensive care, such as the shortage of manpower and material resources, work overload, and lack of availability of professionals for effective teamwork.

Molar-incisor hypomineralization (MIH), dental fluorosis, and caries in rural areas with different fluoride levels in the drinking water.

AIM: This study determined the prevalence of molar-incisor hypomineralization (MIH) and its association with dental fluorosis and caries in children living in rural areas in north-eastern Brazil who are exposed to residual fluoride (F) levels in the drinking water. DESIGN: A census was carried out with 610 schoolchildren aged 6 to 12 years. The European Academy of Paediatric Dentistry criteria, Thysltrup and Fejerskov index, and World Health Organization index were used for diagnosis of MIH, dental fluorosis, and caries detection, respectively. The association between the outcome and exposure variables was determined by robust Poisson regression (P < .05). RESULTS: Water F-levels varied from 0.06 to 1.98 ppm. MIH was not related to fluoride levels in the drinking water, but it showed an inverse and direct correlation with dental caries and fluorosis, respectively. Children with MIH had a higher DMFT, and severe MIH cases were most frequent in children with dental fluorosis. CONCLUSION: Drinking water F-levels were not directly related to the occurrence of MIH in schoolchildren. The severity of MIH, however, was likely to be associated with dental fluorosis in areas with moderate to high fluoride levels in the drinking water.

In situ effect of a CPP-ACP chewing gum on enamel erosion associated or not with abrasion.

OBJECTIVES: The purpose of this study is to analyze the in situ effect of a casein phosphopeptide-stabilized amorphous calcium phosphate (CPP-ACP) chewing gum on human enamel erosion lesion associated or not with abrasion. MATERIAL AND METHODS: A three-way crossover study of 7 days was conducted involving 10 volunteers subjected to the same protocol: (G1) CPP-ACP sugar-free chewing gum, (G2) regular sugar-free chewing gum without CPP-ACP, and (G3) saliva-no chewing gum. An abrasion test was included in each phase. A 3D non-contact profilometry measurement of lesion depth and surface roughness was obtained of sound and eroded surfaces. A salivary calcium concentration was determined for all volunteers. ANOVA followed by Tukey's test were used with a p < 0.05. RESULTS: The enamel depth and the enamel surface roughness of the CPP-ACP gum group were significantly lower than the others (ANOVA, p < 0.05). No significant differences were observed between the treatments when associated with abrasion (p > 0.05). A positive and significant correlation was seen between the lesion depth and enamel surface roughness for GI (r = 0.87, p = 0.00) and GIII (r = 0.79, p = 0.00) groups. The estimated total calcium presented in the saliva after the chewed CPP-ACP gum showed no statistical significance between the mean absorbance values at the different time collections (p > 0.05). CONCLUSIONS: It is demonstrated that the incorporation of the CPP-ACP into a sugar-free gum significantly increased the remineralization/protection of eroded enamel surface. CLINICAL RELEVANCE: The CPP-ACP added to gum may be a suitable alternative vehicle, to deliver calcium ions to saliva and therefore protecting enamel.

Quality of life and associated factors for community health workers in the context of the COVID-19 pandemic in northeastern Brazil.

In this study, we evaluated the quality of life (QoL) and associated factors of community health workers (CHWs) in different urban settings as a contributor to the preparedness of Brazilian primary care for future sanitary emergencies. The sample included 1935 CHWs from 4 state capitals and 4 inland municipalities in northeastern Brazil. Information was collected on QoL (WHOQOL-BREF), work routines, sociodemographics, direct and indirect exposure to violence, general self-efficacy, social support (MSPSS), mental health (SRQ-20) and coronavirus anxiety. The data were subjected to multiple linear regression analysis (α = 5%). In the state capitals, the factors associated with loss of QoL were poor mental health, lack of training, uncertainty about occupational biosafety, and lack of adaptation of services to tend to patients diagnosed with COVID-19. Among the inland municipalities, the main factors were coronavirus anxiety, poor mental health, lack of adaptation of services, lack of training, and lack of personal protective equipment (PPE). A high MSPSS (family and friends) score and self-efficacy had positive impacts on QoL in both urban settings. Our results highlight the need for investment in permanent education, PPE, social support, and mental health care for CHWs.

Assessment of groundwater quality in a region of endemic fluorosis in the northeast of Brazil.

The aim of this study was to estimate the risk for caries and fluorosis in a desertification area, applying the calcium/fluoride concentration ratio of underground water and the quality of water in a selected geographical region. This study was performed in the municipality of São João do Rio do Peixe, located in the tropical semiarid lands of Brazil. A total of 111 groundwater samples were collected. Fluoride concentration varied from 0.11 to 9.33 mg/L. Thirty percent of all samples analyzed showed values above 1.5 mg/L, while 64 % were above the ideal limit of 0.7 mg/L. Mean calcium concentration was 47.6 mg/L, and 14.4 % of all samples presented values above the WHO acceptable limits. The proportional value of calcium/fluoride in water showed that only 12 % of the samples were suitable for dental caries prevention with minimal risk for dental fluorosis. Mapping of the fluoride distribution indicated that approximately 2,465 people could be affected by dental fluorosis and 1,057 people might be affected by skeletal fluorosis. It can be concluded that, in addition to fluoride, many water parameters were not suitable for the drinking water. Mapping out calcium/fluoride ratio may indicate areas of water suitability for caries control, whereas the fluoride concentration solely can indicate the areas with the risk for fluorosis. This approach can be relevant for health authorities for identifying communities where dental caries or dental fluorosis is prevalent.

Influence of sociodemographic factors and Family Health Strategy coverage on oral health promotion procedures: an analysis of Brazilian municipalities in 2019.

Background: The aim of the study was to investigate associations between sociodemographic factors and municipal Family Health Strategy (FHS) coverage and oral health promotion (OHP) procedures in Brazil. Material and Methods: Data were obtained using public information systems and by direct request to the Ministry of Health. Clinical and collective OHP procedures performed in 2019 were analyzed, and sociodemographic covariates were associated with FHS coverage (population covered by FHS teams [FHST] and oral health teams [OHT]). Negative binomial regression models associated outcomes with covariates and estimated the prevalence ratio (PR) and confidence intervals (95%CI). Results: A total of 4,913 municipalities were included. Municipalities with low-income inequality (PR=1.04, 95%CI 1.01 to 1.08), high illiteracy rate (RP=1.06, 95%CI 1.00 to 1.13), and population size of 10,001 to 50,000 inhabitants (PR=1.07, 95%CI 1.02 to 1.12) and 50,001 to 100,000 (PR=1.21, 95%CI 1.12 to 1.30) showed a higher frequency of clinical procedures. In contrast, a low frequency of clinical procedures was associated with reduced vulnerability to poverty (PR=0.83, 95%CI 0.78 to 0.89) and low OHT coverage (PR=0.39, 95%CI 0.33 to 0.45). Regarding collective procedures, the final model showed associations between low frequency and reduced income inequality (PR=0.91, 95%CI 0.87 to 0.95), low per capita income (PR=0.84, 95%CI 0.81 to 0.88), and low (PR=0.53, 95%CI 0.35 to 0.80) and medium Human Development Index (PR=0.79, 95%CI 0.71 to 87). Conclusions: Clinical and collective OHP procedures were associated with sociodemographic conditions and OHT coverage in the FHS. Key words:Health Promotion, Oral Health, Social Determinants of Health, Universal Health Coverage.

Level of natural fluoride in public water supply: geographical and meteorological factors in Brazil's Northeast.

This study analyzed the relationships between the concentration of natural fluoride in public water supply and meteorological and hydrographic factors in a northeastern region of Brazil. This was a descriptive, analytical, ecological, longitudinal, and field study conducted by collecting water in 23 municipalities (2019 to 2020) of four macroregions of Paraíba (Brazil): coast (1), borborema (2), agreste (3), and outback (4). Four collection sites were selected per municipality: two near and two distant from the water treatment plant. Fluoride concentration was determined using a combined ion-specific electrode and classified according to the Collaborating Center of the Ministry of Health in Oral Health Surveillance. Meteorological, hydrographic, and population characteristics were also collected. All analyzed samples showed natural fluoride; macroregions 2 and 4 showed the highest mean fluoride concentration, macroregion 4 presented the highest mean temperature, and all macroregions showed a similar pattern of precipitation. The mean fluoride concentration of the four macroregions was below the appropriate value to prevent caries. An increase in precipitation would decrease the fluoride concentration in water. In conclusion, the concentration of natural fluoride varied according to meteorological and hydrographic factors. The concentration in surface waters increased during periods of low precipitation. Therefore, this study provided important information to support implementation of community water fluoridation in this region.

Temporomandibular disorders: knowledge, competency, and attitudes of predoctoral dental students.

OBJECTIVE: To evaluate knowledge, competency, and attitudes related to temporomandibular disorders (TMD) among predoctoral dental students, and to investigate the curricular organization of contents related to TMD and occlusion. METHODS: Predoctoral dental students (n = 147) answered a questionnaire with topics related to TMD. Another questionnaire evaluated the organization of TMD and occlusion courses. RESULTS: Contents related to TMD and occlusion were taught in the same course in all dental schools. The students' responses showed low agreement with the current gold standards pertaining to TMD. Most students declared that they did not feel confident to treat patients with TMD (62.6%), were not satisfied with the content pertaining to TMD (55.8%), and considered a lack of clinical practice to be the primary limitation in their training (59.2%). DISCUSSION: Students' knowledge of basic concepts related to TMD was limited, highlighting the need for readjustment of the dental curriculum to increase clinical experience.

Mental health of community health workers in the COVID-19 context. / Saúde mental de agentes comunitários de saúde no contexto da COVID-19.

This study aimed to analyze the factors related to the mental health of Community Health Workers (ACS) in the COVID-19 context. A total of 1,935 ACS from four Northeastern capitals and four cities in the inland region of Ceará participated. The following data were collected: sociodemographic; professional; SRQ-20; WHOQOL-Bref, exposure to violence, General Self-Efficacy Scale (EAEG), Multidimensional Scale of Perceived Social Support (MSPSS), COVID-19-related information, and the coronavirus anxiety scale (EAC). Approximately 40.5% had SRQ > 7, signaling high levels of Common Mental Disorders (CMD)/mental health issues. We adopted the Multiple linear (backward) regression. We observed that the increased risk of CMD was influenced by exposure to violence, EAC, not knowing they had COVID-19, not knowing the variables that reduced the risk, the physical and psychological domains of the WHOQOL-Bref, not having increased working hours, and not having had COVID-19. The data reveal the multidimensional dynamics of mental health and help understand the relationship between community violence, COVID-19, quality of life, age, and ESF working time with the mental health of ACS.

O objetivo deste estudo foi analisar os fatores relacionados à saúde mental dos agentes comunitários de saúde (ACS) no contexto da COVID-19. Participaram 1.935 ACS de quatro capitais nordestinas e de quatro cidades do interior do Ceará. Foram coletados dados sociodemográficos e profissiográficos; SRQ-20; WHOQOL-Bref; exposição à violência; Escala de Autoeficácia Geral (EAEG); Escala Multidimensional de Suporte Social Percebido (MSPSS); informações relacionadas à COVID-19 e Escala de Ansiedade para Coronavírus (EAC). 40,5% exibiram SRQ > 7, sinalizando altos níveis de transtornos mentais comuns (TMC)/problemas de saúde mental. Utilizou-se a regressão linear múltiplas (backward). Observou-se que o aumento de risco de TCM foi influenciado pelos seguintes fatores: exposição à violência; EAC; não saber se teve COVID-19; desconhecer as variáveis que diminuíam o risco; os domínios físico e psicológico do WHOQOL-Bref; não ter aumento da jornada de trabalho; e não ter tido COVID-19. Os dados revelam a dinâmica multidimensional da saúde mental e ajudam a compreender a relação entre violência comunitária, COVID-19, qualidade de vida, idade e tempo de atuação na ESF com a saúde mental dos ACS.

Community health workers perspective on the COVID-19 impact on primary health care in Northeastern Brazil.

This article evaluates the COVID-19 pandemic impacts on the Family Health Strategy (FHS) team's work routines across a range of northeast Brazilian cities as perceived by community health workers (CHW). Data on COVID-19, CHW activities, and FHS teams were collected in 2021 by a structured questionnaire. A total of 1,935 CHWs from four state capitals (Fortaleza - Ceará State, João Pessoa - Paraíba State, Recife - Pernambuco State, Teresina - Piauí State) and four hinterland cities (Crato, Juazeiro do Norte, Barbalha, Sobral - Ceará State) participated in the study. Most CHWs were women (82.42%), with mean age 46.25±8.54 years. Many (39.92%) were infected with COVID-19, of which 70.78% believed they were infected in the workplace. A total of 77.82% defined their role as frontline in the fight against COVID-19, 16.07% reported receiving training for COVID-19, and 13.74% had access to sufficient protective equipment. Most (90.27%) believed their work routines were modified by the pandemic, either strengthening (41.46%) or weakening (44.41%) the team spirit. Home visits (60.55%), health promotion actions in schools (75.66%) and in specific community groups (93.96%), and other on-site community services (66.01%) showed a reduction in frequency. The sampled cities revealed a significant heterogeneity regarding responses to the COVID-19 pandemic, possibly associated with a lack of coordination by the Federal Government. Regardless of context, the pandemic led to a reconfiguration of local health systems, workflows, and primary care protocols for FHS teams. The importance of the Brazilian Unified National Health System (SUS) and its potential for reorganization during crisis should be acknowledged while preserving the headway made thus far.

Coordination between Primary Care Teams and Family Health Support Units and influence on Primary Care delivery. / Articulação entre a EqSF/AB e o NASF/AB e sua influência na produção do cuidado no contexto da Atenção Primária à Saúde.

This article aims to compare the implementation of coordinated actions by family health/primary care (FH/PC) teams and extended family health and primary care units (NASF-ABs) in the Northeast and rest of Brazil, and the influence of implementation on collaborative working. The independent variables were 19 coordinated actions assessed by Module II of the 3rd Cycle of the National Program for Improving Primary Care Access and Quality (PMAQ-AB). The three collaborative working outcomes were "FH/PC team readiness to work jointly with the NASF-AB", "support received by the FH/PC team from the NASF-AB", and "The NASF-AB's contribution to resolving patients" needs. The implementation of coordinated actions by the Northeast and at national level was compared using the two-proportions z-test and the influence of these actions on the outcomes was assessed using hierarchical linear regression models: The Northeast implemented more actions that at national level (p<0.05). The implemented actions that had the most positive influence on the three outcomes were "Case conferences", "Joint development of singular therapy plans for complex cases", "Shared appointments" and "Results monitoring". The Northeast implemented more actions and the implemented actions had a positive influence on collaborative working.

O objetivo deste artigo é comparar a realização de ações de articulação entre as equipes EqSF/AB e NASF/AB entre a região Nordeste e Brasil e sua influência no trabalho conjunto das equipes. As variáveis independentes foram 19 ações de articulação investigadas pelo módulo II do 3º Ciclo do PMAQ-AB. Os três desfechos referentes ao trabalho conjunto foram a disponibilidade da EqSF/AB em trabalhar com o NASF/AB, o apoio recebido do NASF/AB e a contribuição do trabalho deste para a resolutividade das ações para os usuários. A comparação entre o Nordeste e o Brasil na realização das ações de articulação foi realizada pelo Teste Z e a influência final de tais ações nos desfechos foi avaliada por Modelo Hierárquico de Regressão Linear. A região Nordeste realizou mais ações de integração entre a EqSF/ AB e o NASF/AB (p<0,05). As ações realizadas que apresentaram maior influência positiva nos três desfechos foram "discussão de casos", "elaboração conjunta do Projeto Terapêutico Singular", "realização de consultas compartilhadas" e "monitoramento dos resultados". A região Nordeste realizou mais ações de articulação, e elas apresentaram influências positivas no trabalho conjunto.

Dental pain associated with untreated dental caries and sociodemographic factors in 5-year-old children.

BACKGROUND: The aim of this study was to assess the prevalence of dental pain and to examine its association with untreated dental caries in 5-year-old children. MATERIAL AND METHODS: This was a cross-sectional study of 261 5-year-old children in Northeast Brazil. Parents answered questions about their socioeconomic conditions and their children's toothache. Trained dentists assessed dental caries using the decayed, missing and filled teeth (dmf-t) index. Binary logistic regression models were used to estimate the unadjusted and adjusted odds ratios (ORs) and the confidence intervals (95% CIs) for the association of dental pain with covariates. The significance level was set at five percent. RESULTS: The prevalence of dental pain was 28.7%, and 48.2% of children had untreated dental caries. Dental pain was associated with untreated dental caries (OR=5.7; 95% CI: 3.1-10.53; p<0.001) and living with one parent or other family members (OR=2.3; 95% CI: 1.2-4.4; p=0.008). Sociodemographic factors were not associated with dental pain. CONCLUSIONS: The prevalence of dental pain in preschool children is high, and this condition is associated with both untreated dental caries and living with one parent or other family members. Key words:Toothache, socioeconomic factors, dental caries.

Presence of molar-incisor hypomineralization is associated with dental caries in Brazilian schoolchildren.

This study aimed to identify the prevalence of molar-incisor hypomineralization (MIH) in schoolchildren and its association with dental caries experience. This was a cross-sectional study with a sample of 471 children aged 8 to 10 years. Data were collected via a sociodemographic questionnaire. Intra-oral clinical examination was done to identify and diagnose MIH (EAPD Criteria) as well as dental caries (ICDAS Index). Statistical analyses were performed with Person's Chi-square, Fisher's exact, and Mann-Whitney tests, and Poisson regression models were built. Statistical significance was set at an alpha-level of 0.05. The prevalence of MIH in our participants was 9.8%, with lesions being mostly of the mild form (65.2%) and affecting the first permanent molars but not the incisors in 54.2% of the children. Dental caries was observed in 88.1% of subjects. We observed a significant association between dental caries and the following variables: presence of MIH (p < 0.01; PR = 1.13), dental visit (p < 0.02; PR=0.92), and parents or legal guardians' education level (p < 0.05; PR = 1.07). A MIH diagnosis was also significantly associated with family income (p < 0.05; PR = 4.09). Children with MIH had more caries lesions on molar surfaces (p < 0.01; PR = 4.05). The prevalence of MIH was found to be moderate, based on previous studies, and the presence of enamel defect was associated with dental caries. The teeth most affected by MIH lesions were the first permanent molars.

Dental Fear in Children: Association with Dental Caries and Molar Incisor Hypomineralization.

The aim of this study was to investigate the prevalence of dental fear and to evaluate its association with dental caries and molar incisor hypomineralization (MIH) in schoolchildren aged 8-10 years from a municipality in Northeastern Brazil. Data from 466 students enrolled in urban public schools in a cross-sectional study were collected. Parents/guardians answered a questionnaire addressing sociodemographic characteristics, dental fear was measured by means of the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS) and clinical examinations were performed by three calibrated examiners for diagnosis of dental caries, using the International Caries Detection & Assessment System - ICDAS II and a previously validated index for MIH. Descriptive data analysis was performed, and associations between dental fear, dental caries and MIH were analyzed using robust Poisson regression for complex samples (p<0,05). The prevalence of dental fear was 21.6%, and the mean total CFSS-DS score was 29.97 (CI 95%=29.05-30.89). In the multivariate adjusted model, the prevalence of dental fear was associated to family income (PR=1.78; CI 95%=1.02-3.08; p= 0.041). Monthly family income was associated with dental fear in children, whereas dental caries and MIH were not associated with dental fear.

Degree of family cohesion and social class are associated with the number of cavitated dental caries in adolescents.

The aim of this study was to evaluate the association between number of cavitated dental caries in adolescents and family cohesion, drug use, sociodemographic factors and visits to the dentist. A cross-sectional study was conducted with 746 adolescents aged 15 to 19 years from Campina Grande, Brazil. The parents answered a questionnaire addressing sociodemographic data, and the adolescents answered questionnaires on drug use, type of family cohesion and visits to the dentist. Two examiners underwent training and calibration exercises (K > 0.80) to diagnose dental caries using the Nyvad criteria. A directed acyclic graph was created to select the variables to be controlled in the statistical model. Associations between the independent variables and the outcome were determined using robust Poisson Regression analysis for complex samples (α = 5%). Rate ratios (RR) and 95% confidence intervals (CI) were calculated. The prevalence of dental caries and cavitated lesions among the adolescents was 92.8% and 41.6%, respectively. The following variables remained associated with the number of cavitated lesions in the multivariate analysis: disengaged (RR: 6.30; 95%CI: 1.24-31.88; p = 0.028 ), separated (RR: 4.80; 95%CI: 1.03-22.35; p = 0.046) and connected (RR: 5.23; 95%CI: 1.27-21.59; p = 0.024) levels of family cohesion, and high social class (RR: 0.55; 95%CI: 0.39-0.76; p = 0.001). In conclusion, this paper posits that adolescents with a lower socioeconomic status, and those whose family cohesion was classified as disengaged, separated or connected, had a larger number of cavitated lesions.

Promoção de Saúde Bucal no trabalho em áreas rurais: ecos de cirurgiões-dentistas / Oral Health Promotion at the workplace in rural areas: echoes from dental surgeons

RESUMO Estudo compreendeu o trabalho dos cirurgiões-dentistas da Estratégia Saúde da Família, na perspectiva da Promoção da Saúde Bucal (PSB) em território rural. Trata-se de uma investigação transversal e qualitativa. A coleta dos dados foi realizada a partir de entrevistas semiestruturadas realizadas com quatorze profissionais que atuavam em equipes de saúde bucal rurais do estado da Paraíba. Para compreensão e sistematização dos dados, adotou-se a análise de conteúdo temática. O referencial teórico condutor do método considerou pilares, valores e princípios da Promoção da Saúde (PS). As narrativas revelam conceitos imprecisos de PSB, restringindo-os às atividades de prevenção aos agravos bucais. Existem potencialidades e fragilidades nas ações de PSB em áreas rurais. Há desigualdades quanto às unidades de apoio e existem populações rurais sem qualquer assistência aos serviços especializados de saúde bucal. Observou-se envolvimento dos profissionais nas práticas campanhistas e nas metas com gestantes. Existem dificuldades na formação de grupo, e as ações intersetoriais são praticamente resumidas à parceria entre saúde/educação. As realidades são discrepantes frente ao apoio da gestão. Os discursos apontaram para ações de PSB capazes de produzir autoestima e melhorar a qualidade de vida, pautadas na integralidade e nos valores de solidariedade e humanização.

ABSTRACT This study included the work of dental surgeons of the Family Health Strategy, from the perspective of Oral Health Promotion (OHP) in rural territory. This is a cross-sectional and qualitative investigation. Data collection was performed through semi-structured interviews carried out with fourteen professionals who worked in rural oral health teams from the state of Paraíba. To understand and systematize the data, thematic content analysis was adopted. The theoretical framework that guided the method considered pillars, values and principles of Health Promotion (HP). Narratives reveal imprecise OHP concepts, restricting them to oral disease prevention activities. There are potentialities and weaknesses in the OHP actions in rural areas. There are inequalities regarding support units and there are rural populations without any assistance to specialized oral health services. Professionals' involvement was observed in the campaign practices and in the goals with pregnant women. There are difficulties in group formation, and intersectoral actions are practically limited to the partnership between health/education. The realities are discrepant in the face of management support. The speeches pointed to OHP actions capable of producing self-esteem and improving quality of life, based on integrality and the values of solidarity and humanization.

Oral Health Impact Profile: need and use of dental prostheses among Northeast Brazilian independent-living elderly.

This study aimed to explore the association between use and need of dental prostheses to the quality of life in elderly individuals in a  Referral Center for Elderly Care in the northeastern of Brazil. A cross-sectional study was developed with 199 elderlies of both sexes. Data were collected from clinical examinations (WHO criteria) and a questionnaire regarding socioeconomic status, Oral Health Impact Profile index (OHIP-14) by a single calibrated examiner with Kappa = 0.91. Data were analyzed using Mann-Whitney test, Poisson regression (p<0,05). The sample consisted of 84.9% women, mean age of 70.02 (sd±6.50) years. There was an independent association between quality of life and the covariates sex and need of dental prostheses. Men showed lower values of the score (PR = 0.734, p = 0.011) than women. Individuals without normative need for dental prostheses showed lower values of OHIP-14 (PR = 0.767; p = 0.003) than those in need.

Fluoride in Bottled Waters Consumed in Northeastern Brazil

ABSTRACT Objective: To assess the fluoride concentration of bottled waters from municipalities in northeastern Brazil. Material and Methods: Bottled mineral waters were purchased in two periods at different commercial places of four large municipalities (João Pessoa, Campina Grande, Patos, and Cajazeiras) in the Paraíba state. The municipalities selected to present the following annual average temperature: João Pessoa 26.5 °C, Campina Grande 23.3 °C, Patos and Cajazeiras 27.5 °C. Fluoride concentration was determined using a combined ion-specific electrode. Readings (in mV) were conducted in triplicates for each standard solution and converted into fluoride concentration (mg F/L) using the Excel® software. Results: A total of 72 samples from six brands of bottled water were analyzed. The fluoride concentrations of all samples were low (0.11-0.21mg/L) but higher than those reported on the label and varied among different batches of the same brand. Conclusion: The fluoride levels in bottled water vary among brands, and these actual values are not stated in the labels.

Effectiveness of an intervention with mothers to stimulate children under two years.

OBJECTIVE: To analyze the effectiveness of an educational intervention with mothers to stimulate children under two years of age at risk for neuropsychomotor development. METHOD: Before-after intervention study, conducted with 52 mothers of children under two years old, enrolled in reference centers in early childhood education. Initially, maternal knowledge regarding child development and stimulation was assessed through a structured instrument. Then, workshops were held with the mothers and, after three months, maternal knowledge was revised, reapplying the data collection instrument. In the analysis, descriptive and inferential statistics were used, applying the McNemar and Wilcoxon tests and the Rasch Model from the Item Response Theory. RESULTS: after the intervention, there was a significant increase in scores regarding the following aspects: knowledge of mothers about child development and stimulation from 5.77 ± 1.85 to 18.60 ± 1.94 (p <0.001); reduction of the maternal difficulty index in answering the instrument questions from 1.17 ± 0.57 to -1.98 ± 1.63 (p 0.01). CONCLUSION: the educational intervention contributed to the improvement of maternal knowledge regarding the development and forms of child stimulation, corroborating the importance of this action to advance the health of children at risk under maternal care at home.