Individual and collective empowerment and associated factors among Brazilian adults: a cross-sectional study.

BACKGROUND: The empowerment embedded in the health area is defined as a process that can facilitate control over the determinants of health of individuals and population as a way to improve health. The aim of this study was to verify the association between individual and collective empowerment with sociodemographic conditions, lifestyle, health conditions and quality of life. METHOD: A cross-sectional analytical study was conducted with 1150 individuals (aged 35 to 44 years). The empowerment was determined by questions from the Integrated Questionnaire for the Measurement of Social Capital (IQ-MSC). The quality of life was measured using the WHOQOL (World Health Organization Quality of Life-Bref). Lifestyle and health conditions were obtained by adapted questions from the Fantastic Lifestyle Questionnaire The DMFT Index was incorporated in the health conditions questions. Logistic regression or multinomial regression was performed. RESULTS: The practice of physical activity was related to individual (OR: 2.70) and collective (OR: 1.57) empowerment. Regarding individual empowerment, people with higher education level (5-11 years - OR: 3.46 and ≥12 years - OR: 4.41), who felt more able to deal with stress (OR:3.76), who presented a high score on quality of life (psychological domain) (OR:1.23) and that smoked (OR:1.49) were more likely to feel able to make decisions and participate in community activities. The increase in the DMFT Index represented less chance of individuals to feel more able to make decisions (OR: 0.96). Regarding the collective empowerment, being religious (catholic) (OR: 1.82), do not drink or drink just a little (OR: 1.66 and 2.28, respectively), and increased score of overall quality of life (OR: 1.08) were more likely to report that people cooperate to solve a problem in their community. CONCLUSION: The two approaches to empowerment, the individual and collective are connected, and the physical activity showed to be a good strategy for the empowerment construction.

Epigenetic regulation of matrix metalloproteinase expression in ameloblastoma.

BACKGROUND: An ameloblastoma is a benign odontogenic neoplasm with aggressive behaviour and high recurrence rates. The increased expression of matrix metalloproteinases (MMPs) has been reported in ameloblastomas. In the present study, we hypothesised that epigenetic alterations may regulate MMP expression in ameloblastomas. METHODS: We investigated the methylation status of the genes MMP-2 and MMP-9 in addition to mRNA transcription and protein expression in ameloblastomas. Methylation analysis was performed by both methylation-specific polymerase chain reaction (MSP-PCR) and restriction enzyme digestion to evaluate the methylation profile of MMP-2 and MMP-9 in 12 ameloblastoma samples and 12 healthy gingiva fragments, which were included as controls. Furthermore, we investigated the transcription levels of the genes by quantitative reverse-transcription PCR (qRT-PCR). Zymography was performed to verify protein expression in ameloblastomas. RESULTS: The ameloblastomas showed a high frequency of unmethylated MMP-2 and MMP-9, whereas the healthy gingival samples presented a sharp prevalence of methylated MMPs. Higher expression levels of MMP-9 were found in ameloblastomas compared to healthy gingiva. However, no significant differences in the MMP-2 mRNA expression between groups was found. All ameloblastomas showed positive expression of MMP-2 and MMP-9 proteins. CONCLUSIONS: Our findings suggest that expression of MMP-9 is increased in ameloblastomas and is possibly modulated by unmethylation of the gene.

Relationship Between Quality of Complete Dentures and User Satisfaction at 1 and 5 Years Postinsertion.

AIMS: To evaluate the effects of complete denture (CD) quality and user satisfaction on the use of CDs provided by primary care services at 1 and 5 years postinsertion. MATERIALS AND METHODS: A random sample of 233 individuals were evaluated regarding the use of maxillary and/or mandibular CDs at 1 and 5 years after insertion; at both time points, denture quality, integrity, and user satisfaction were measured. The covariates included age, gender, marital status, years of education, family income, past use of CD, time since maxillary teeth loss, mandibular ridge height, and frequency of return visits to the dentist after receiving the prostheses. The effect of the variables on the use of CDs throughout the period was estimated using logistic regression models with random effects in the intercept. RESULTS: Overall, 64.9% and 64.1% of the participants were using their CD at 1 and 5 years, respectively. Of those who used the pair of prostheses at 5 years, 86.3% reported using them in the first evaluation. Use of CDs at 1 year was greater among users with some degree of education, higher satisfaction, and those whose CD had adequate stability and free functional space. Use of CDs at 5 years was greater in satisfied users and those with a stable CD. CONCLUSION: Denture quality and user satisfaction were associated with the use of CDs after 1 and 5 years. CD use was greater in individuals who had used it for 1 year, indicating greater abandonment in the first year than in other periods.

Facial trauma among victims of terrestrial transport accidents.

INTRODUCTION: In developing countries, terrestrial transport accidents - TTA, especially those involving automobiles and motorcycles - are a major cause of facial trauma, surpassing urban violence. OBJECTIVE: This cross-sectional census study attempted to determine facial trauma occurrence with terrestrial transport accidents etiology, involving cars, motorcycles, or accidents with pedestrians in the northeastern region of Brazil, and examine victims' socio-demographic characteristics. METHODS: Morbidity data from forensic service reports of victims who sought care from January to December 2012 were analyzed. RESULTS: Altogether, 2379 reports were evaluated, of which 673 were related to terrestrial transport accidents and 103 involved facial trauma. Three previously trained and calibrated researchers collected data using a specific form. Facial trauma occurrence rate was 15.3% (n=103). The most affected age group was 20-29 years (48.3%), and more men than women were affected (2.81:1). Motorcycles were involved in the majority of accidents resulting in facial trauma (66.3%). CONCLUSION: The occurrence of facial trauma in terrestrial transport accident victims tends to affect a greater proportion of young and male subjects, and the most prevalent accidents involve motorcycles.

Tobacco use and friendship networks: a cross-sectional study among Brazilian adolescents.

AIM: To determine the prevalence of tobacco use and its association with types of friendship networks, socioeconomic status and gender among Brazilian adolescents. METHODS: A cross-sectional study was carried out with a representative sample of 905 students aged 15 to 19 years. Information on social networks and tobacco use was collected by the self-administered questionnaire 'Alcohol, Smoking and Substance Involvement Screening Test" and the question "What is your most important group of close friends?'. Socioeconomic status was assessed using an area-based social vulnerability index and type of school. Multinomial logistic regression analysis was employed to test associations between tobacco use and the independent variables. RESULTS: The overall prevalence of tobacco use was 18.9%. Female adolescents had 3.80-fold greater odds of reporting weekly to daily tobacco use compared to male adolescents. Participants who reported that their most important groups of close friends were from church had a lower risk of reporting weekly to daily tobacco use in comparison to those who reported that their best friends were from school. CONCLUSIONS: The prevalence of tobacco use was high and was associated with school-based (as compared to church-based) friendship networks, female gender and higher area-level socioeconomic status.

Implications of edentulism on quality of life among elderly.

This study aimed was to test the association between quality of life and edentulism among elderly individuals in a city in southeastern Brazil. This cross-sectional study was carried out with 163 individuals aged 60 years or older, functionally independent and non-institutionalized. Data were collected with a questionnaire and oral examination. The edentulism was the dependent variable. The independent variables were sex, age, household income and quality of life (WHOQOL-Old) and their scores. To assess the association between the dependent variable and independent variables was used bivariate analysis (p < 0.10). Poisson regression model was performed, adjusting for age and sex. The average age of participants was 69 years (± 6.1), 68.7% were female and 52.8% were diagnosed as completely edentulous (90% CI: 0.33-1.24). When the independent variables were associated to the prevalence of edentulism, statistically significant associations were found for age (p = 0.03) and social participation dimension of the WHOQOL-Old (p = 0.08). In the Poisson regression, social participation remained statistically associated to edentulism {RP = 2.12 [90% CI (1.10-4.00)]}. The social participation proved to have a significant association to edentulism, thereby attesting to the negative effect of this condition on social aspects.

Impact of periodontal disease on the quality of life of diabetics based on different clinical diagnostic criteria.

The aim of this study was to determine the impact of periodontal disease on the quality of life of individuals with diabetes according to different clinical criteria (I-AAP, II-Beck, III-Machtei, IV-Lopez, V-Albandar, VI-Tonetti, and VII-CPI). This cross-sectional study sampled 300 individuals in Belo Horizonte, Brazil. The Oral Health Impact Profile was used to measure the impact of periodontal disease on quality of life. Prevalence of periodontal disease was 35.3%, 30.7%, 35.0%, 9.7%, 92.3%, 25.3%, and 75.3% using criteria I, II, III, IV, V, VI, and VII, respectively. The III-Machtei (P = 0.043) and IV-Lopez (P < 0.001) criteria were associated with OHIP-14; functional limitation was associated with IV-Lopez (P = 0.006) and V-Albandar (P = 0.018) criteria. Pain was only associated with V-Albandar criteria (P < 0.001). Psychological discomfort was associated with the IV-Lopez (P = 0.018) criteria. Physical disability was associated with the IV-Lopez (P = 0.047) and V-Tonetti (P = 0.046) criteria. Being handicapped was associated with the I-AAP (P = 0.025) and II-Beck (P = 0.041) criteria. Concepts of health and disease determined by clinical diagnostic criteria may influence the assessment of the impact of periodontal disease on diabetics' quality of life.

Perceptions of adolescents and young people regarding endemic dental fluorosis in a rural area of Brazil: psychosocial suffering.

Severe dental fluorosis is endemic in some rural areas of Brazil. This paper describes the psychosocial consequences of this condition and how it has affected the self-esteem of adolescents and young people in a rural area in Brazil. Semi-structured, face-to-face interviews were carried out with 23 adolescents and young people affected by severe dental fluorosis and 14 of their teachers. The study revealed the affected individuals were embarrassed to smile at strangers due to a presumed association between fluorosis and a lack of dental hygiene. Further findings include conflicts between affected and non-affected students at school, problems in pursuing a romantic relationship and uncertainties regarding a professional future. Disbelief and scepticism were observed regarding the ethical position that science can offer a solution to the problems stemming from the disease. Lesions from severe dental fluorosis appear to be a stigmatizing factor and have contributed toward suffering and self-exclusion among an entire generation of adolescents and young people.

Brazilian HIV-infected population: assessment of the needs of endodontic treatment in the post-highly active antiretroviral therapy era.

INTRODUCTION: The effects of highly active antiretroviral therapy (HAART) on the prevalence of endodontic diseases in HIV-infected individuals have not been reported. METHODS: The purpose of this study was to determine and compare sex, age, need for root canal treatment, CD4 and CD8 lymphocyte counts, HIV viral load, and antiretroviral therapy in 222 HIV-infected individuals who were monitored at an HIV Reference Center in Brazil. RESULTS: One hundred sixty-six patients comprised the studied population; the rate of the need for endodontic treatment was 14.5%. There was a positive correlation between the CD4 + T-cells count (< 500 cell/ mm(3)) and the need for endodontic treatment, but there was no statistical difference between the need for endodontic treatment and the HIV viral load or the CD4+/CD8+ ratio in T-cell counts. Of the population that needed endodontic treatment, 79.2% was taking the HAART regimen, and the majority of the studied population was female. CONCLUSION: We found that those HIV-infected individuals needing endodontic treatment had a lower CD4 + T-cell count, which probably correlated with a lower adherence to the HAART regimen.