RESUMO
Food-based dietary guidelines (FBDGs) are tools for promoting healthy eating habits. For the population of children under two years old in Latin America and the Caribbean (LAC), there is a lack of reviews analyzing the quality of these guidelines. The objective of this systematic review is to evaluate publicly available FBDGs for the population under two years old in LAC until mid-2023. Guidelines aimed at caregivers of children were included, sourced from government websites in LAC countries and the Food and Agriculture Organization (FAO) portal. Documents targeted at healthcare professionals were excluded. For qualitative analysis, the Agree II guidelines assessment tool and the FAO guide principles for developing healthy and sustainable diets were used. The results showed that more recently released and revised FBDGs with a greater number of pages obtained better scores in both assessments. Additionally, out of the 32 LAC countries, only 13 had these FBDGs available on websites for public access. As a limitation, this study faced challenges in standardizing the searches on government websites. The authors emphasize the need to develop FBDGs for the population under two years old that align with current health and sustainability needs and promote health education.
Assuntos
Política Nutricional , Humanos , América Latina , Região do Caribe , Lactente , Dieta Saudável/normas , Fenômenos Fisiológicos da Nutrição do Lactente , FemininoRESUMO
Objetivou-se avaliar a educação permanente em saúde voltada para cirurgiões-dentistas vinculados ao Sistema Único de Saúde (SUS) e suas habilidades e competências desenvolvidas durante o Curso de Atenção e Cuidado da Saúde Bucal da Pessoa com Deficiência. Foi um estudo transversal e qualitativo com uso de questionário semiestruturado, a amostra ocorreu por conveniência. Os participantes em sua maioria eram do sexo feminino (90%), com médiade idade de 40 anos e tempo médio de formação de 16,9 anos. Após o término do curso, 90% continuaram atuando no SUS e, desses, 82,5% trabalhando na atenção primária. Ao relatarem sobre se sentirem aptos a atender pessoas com deficiência, após a finalização do curso, 80% responderam que sim e em casos de menor complexidade. Houve diferença estatística quando comparado o tempo de formado com se teve ou não a disciplina de pacientes com necessidades especiais durante a graduação (p=0,02). Conclui-se que os egressos do curso participantes da pesquisa conseguem resolver casos que demandam menor complexidade, presumindo que a qualificação recebida permite responder com maior resolutividade os atendimentos dos pacientes com deficiência (AU).
El objetivo fue evaluar la educación continua en salud dirigida a cirujanos dentistas vinculados al Sistema Único de Salud (SUS) y sus habilidades y competencias desarrolladas durante el Curso de Atención y Atención en Salud Bucal a Personas con Discapacidad. Fue un estudio transversal y cualitativo mediante el uso de un cuestionario semiestructurado, la muestra se utilizó por conveniencia. La mayoría de los participantes eran mujeres (90%), con una edad media de 40 años y un tiempo medio de formación de 16,9 años. Después de finalizar el curso, el 90% continuó trabajando en el SUS y, de ellos, el 82,5% trabajó en la atención primaria. Al reportar sentirse capaz de atender a personas con discapacidad, luego de finalizar el curso, el 80% respondió que sí y enlos casos de menor complejidad. Hubo diferencia estadística al comparar el tiempo transcurrido desde la graduación con si hubo o no una asignatura sobre pacientes con necesidades especiales durante la graduación (p=0,02). Se concluye que los egresados del curso que participan en la investigación son capaces de resolver casos que requieren menor complejidad, asumiendo que la calificación recibida les permite responder con mayor resolución a la atención de pacientes con discapacidad (AU).
This study aimed to evaluate continuing health education for dental surgeons linked to the Unified Health System (SUS) and the skills and competencies developed during an oral health care and attention course for people with disabilities. This cross-sectional, qualitative study used a semi-structured questionnaire and convenience sample. Most participants were women (90%), with an average age of 40 years and average training duration of 16.9 years. After finishing the course, 90% of the students continued working in the SUS, and of these, 82.5% worked in primary care. When reporting feeling able to serve people with disabilities after completing the course, 80% responded yes in cases of less complexity. There was a significant difference between the time since graduation and whether there was a subject with special needs at graduation (p=0.02). It was concluded that graduates participating in the study could solve cases that require less complexity if the qualifications received allowed them to respond with greater resoluteness to the care of patients with disabilities (AU).
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Atenção Primária à Saúde , Saúde Bucal , Pessoas com Deficiência , Educação Continuada , Sistema Único de Saúde , Distribuição de Qui-Quadrado , Estudos Transversais/métodos , Educação Profissional em Saúde PúblicaRESUMO
This study aimed to assess whether patients feel safe or anxious when receiving dental care at a teaching clinic; the study was carried out from the perspective of patients, given the biosafety protocol during the 2019 Coronavirus (COVID-19) pandemic. Thiscross-sectional study was carried out with 217 patients assisted by students in the Dental Clinic of the Pontifícia Universidade Católica do Paraná. A semi-structured questionnaire was used to collect sociodemographic data, humanization and the safety protocols followed during care. Multivariate analysis was performed using Poisson regression (PR), and p values ≤0.05 were understood. Around 90% of patients reported that students were attentive, communicative, welcoming and confident during treatment about the risk of contracting COVID-19 during care. Patients who showed anxiety during treatment were 32.2%. Some patients were unable to keep their distance in the waiting room (PR 3.439) and did not feel safe during the appointment (PR 2.64) had a higher prevalence of anxiety during dental care. Anxiety about care was associated with the individual's color or ethnicity, ability to maintain social distancing in the waiting room, and feeling safe when receiving care (AU).
El objetivo de este estudio fue evaluar si los pacientes se sienten seguros o ansiosos al recibir atención odontológica en una clínica docente; el estudio se realizó desde la perspectiva de los pacientes, teniendo en cuenta el protocolo de bioseguridad durante la pandemia del Coronavirus 2019 (COVID-19). Se trata de un estudio transversal realizado con 217 pacientes atendidos por estudiantes de la Clínica Odontológica de la Pontificia Universidad Católica de Paraná. Se utilizó un cuestionario semiestructurado para recolectar datos sociodemográficos, humanización y protocolos de seguridad seguidos durante la atención. El análisis multivariado se realizó mediante regresión de Poisson (RP), con valores de p ≤0,05. Alrededor del 90% de los pacientes informaron que los estudiantes se mostraron atentos, comunicativos, acogedores y confiados durante el tratamiento sobre el riesgo de contraer COVID-19 durante el tratamiento. Los pacientes que demostraron ansiedad durante el tratamiento fueron el 32,2%. Algunos pacientes no pudieron mantener la distancia en la sala de espera (RP 3.439) y no se sintieron seguros durante la consulta (RP 2.64) y tuvieron mayor prevalencia de ansiedad durante la atención odontológica. La ansiedad con respecto a la atención se asoció con elcolor o el origen étnico del individuo, la capacidad de mantener el distanciamiento social en la sala de espera y sentirse seguro al recibir atención (AU).
O objetivo deste estudo foi avaliar se os pacientes se sentem seguros ou ansiosos ao receber atendimento odontológico em uma clínica-escola; o estudo foi realizado sob a perspectiva dos pacientes, tendo em vista o protocolo de biossegurança durante a pandemia do Coronavírus 2019 (COVID-19). Trata-se de um estudo transversal realizado com 217 pacientes atendidos por estudantes da Clínica Odontológica da Pontifícia Universidade Católica do Paraná. Foi utilizado questionário semiestruturado para coletar dados sociodemográficos, sobre humanização e protocolos de segurança seguidos durante o atendimento. A análise multivariada foi realizada por meio de regressão de Poisson (RP), sendo compreendidos valores de p ≤0,05. Cerca de 90% dos pacientes relataram que os estudantes se mostraram atentos, comunicativos, acolhedores e confiantes durante o tratamento sobre o risco de contrair a COVID-19 durante o atendimento. Os pacientes que demonstraram ansiedade durante o tratamento foram 32,2%. Alguns pacientes não conseguiram manter distância na sala de espera (RP 3,439) e não se sentiram seguros durante a consulta (RP 2,64) tiveram maior prevalência de ansiedade durante o atendimento odontológico. A ansiedade em relação ao atendimento esteve associada à cor ou etnia do indivíduo, capacidade de manter distanciamento social na sala de espera e sentir-se seguro ao receber atendimento (AU).
Assuntos
Humanos , Assistência Odontológica , Ansiedade ao Tratamento Odontológico/psicologia , Contenção de Riscos Biológicos , Empatia , COVID-19/transmissão , Distribuição de Qui-Quadrado , Modelos Lineares , Estudos Transversais/métodos , Análise Multivariada , Inquéritos e Questionários , Ansiedade ao Tratamento Odontológico , Clínicas OdontológicasRESUMO
OBJECTIVE: To describe the sociodemographic and gestational profile of HIV-positive women in Curitiba-PR, years 2018-2020. METHOD: Observational, cross-sectional research, with data obtained from the Information System of Diseases of Notification of Pregnant Women. Data were analyzed for consistency exploration, description and analysis. RESULTS: The sample consisted mostly of women aged 13-30 years, white and with incomplete elementary school. Prenatal care was performed by 93.8% of pregnant women, 66.1% of whom knew their serological status before prenatal care and 45% received notification in the first gestational trimester. Access to antiretroviral medication occurred for 82.4% of pregnant women and for 74.6% the pregnancy outcome was alive newborns. The statistical variables associated with prenatal care were pregnancy evolution, ART prophylaxis, type of delivery and ART at delivery (p<0.00). CONCLUSION: The pregnant women in the sample presented desired gestational indicators. The collected data allowed describing the sample's profile and evaluating the performance of the health policy for pregnant women.
Assuntos
Infecções por HIV , Complicações Infecciosas na Gravidez , Feminino , Humanos , Recém-Nascido , Gravidez , Brasil/epidemiologia , Estudos Transversais , Infecções por HIV/prevenção & controle , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Complicações Infecciosas na Gravidez/tratamento farmacológico , Gestantes , Cuidado Pré-NatalRESUMO
BACKGROUND: Rapid demographic, epidemiological, technological, cultural/behavioural, and educational transitions, as they become more complex, demand new integrated and complementary professional skills and abilities. Interprofessional Education (IPE) is a promising alternative to deal with these changes, especially in courses in the health area. This systematic review was to explore the potentialities and limitations of IPE, from the perspective of undergraduate students, through a thematic synthesis of qualitative studies. METHODS: A thematic synthesis of qualitative studies was conducted. The question elaborated for this review was: "What is the impact of interprofessional education on the teaching and learning of students in the health area inserted in Higher Education Institutions?". The search strategy was performed in the electronic databases PubMed, Latin American and Caribbean Literature in Health Sciences (LILACS), Cochrane Library, and Scientific Electronic Library Online (SciELO). In addition, searches were carried out in grey literature on the ERIC platforms, ProQuest Disserts and Theses, and Academic Google. The assessment of the quality of the studies was carried out using the Critical Appraisal Skills Programme tool. Data were summarized through thematic synthesis. From the databases, 8,793 studies were identified. After standardized filters procedures, critical summaries, and assessment of relevance to the eligibility criteria, 14 articles were included. RESULTS: The synthesis of the studies revealed the potential of this teaching approach, arranged in three analytical themes: learning from each other and about them; the value of education and interprofessional practice; patient-centred health care. On the other hand, some limitations were also identified, such as barriers related to EIP; the difficulties related to teaching methodologies. CONCLUSION: Overcoming the identified limitations can enhance the results of the IPE, in view of its impact on the education of students and on the health care of the population.
Assuntos
Educação Interprofissional , Estudantes , Humanos , Atenção à Saúde , Escolaridade , Pesquisa Qualitativa , Relações InterprofissionaisRESUMO
The objective of this systematic review was to analyze the quality of the food frequency instruments/scales used in dentistry while considering their psychometric properties. The databases consulted were PubMed (August 7, 2020), Scopus (August 27, 2020), Web of Science (August 27, 2020), Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Dentistry and Oral Sciences Source (via EBSCO) (August 28, 2020), LILACS and BBO (August 25, 2020), gray literature: Proquest (October 1, 2020), Capes Theses Bank (October 1, 2020), Brazilian Digital Library of Theses and Dissertations (October 1, 2020), Google Scholar (October 2, 2020), and proceedings of the International Association for Dental Research (IADR) (October 10, 2020). All databases were updated on December 12, 2022. Articles were initially selected by reading the 6,421 titles and 13 abstracts selected, followed by reading the 8 articles included for full text reading to confirm the eligibility criteria, with the aid of Rayyan software. Databases of the construction and/or validation of instruments/scales for assessing food consumption for use in dentistry (in clinical contexts and/or epidemiological studies), with or without assessment of their psychometric properties, were included. Review studies, letters to editors, and research protocols were excluded. Risk of bias assessment was performed according to the Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist. The extracted data were author, country, instrument language, sample, assessment instrument, instrument structure, type of food, instruments compared with the clinical condition, adaptation of an existing instrument, and psychometric properties evaluated. The selection, risk of bias analysis, and data extraction processes were performed by two independent evaluators. Seven studies were identified. The instruments available in the literature were in English, Japanese, Creole, and Malay. Only one study performed translation and cross-cultural validation of an instrument, whereas the others were construction studies. One study did not assess psychometric properties. Regarding the quality assessment and general classification of the studies by the COSMIN checklist, all were considered "inadequate," with reliability (test-retest) being the most validated psychometric property; only one study carried out the validation of all psychometric properties measured in COSMIN. Regarding the quality of the instruments presented, all the studies were classified as "inadequate" in the general assessment. Advances are needed in the validation process.
Assuntos
Odontologia , Humanos , Reprodutibilidade dos Testes , Psicometria/métodos , PubMed , Inquéritos e QuestionáriosRESUMO
ABSTRACT Objective: To describe the sociodemographic and gestational profile of HIV-positive women in Curitiba-PR, years 2018-2020. Method: Observational, cross-sectional research, with data obtained from the Information System of Diseases of Notification of Pregnant Women. Data were analyzed for consistency exploration, description and analysis. Results: The sample consisted mostly of women aged 13-30 years, white and with incomplete elementary school. Prenatal care was performed by 93.8% of pregnant women, 66.1% of whom knew their serological status before prenatal care and 45% received notification in the first gestational trimester. Access to antiretroviral medication occurred for 82.4% of pregnant women and for 74.6% the pregnancy outcome was alive newborns. The statistical variables associated with prenatal care were pregnancy evolution, ART prophylaxis, type of delivery and ART at delivery (p<0.00). Conclusion: The pregnant women in the sample presented desired gestational indicators. The collected data allowed describing the sample's profile and evaluating the performance of the health policy for pregnant women.
RESUMEN Objetivo: Describir el perfil sociodemográfico y gestacional de mujeres VIH positivas en Curitiba-PR, años 2018-2020. Método: Investigación observacional, de corte transversal, condatos obtenidos del Sistema de Información de Enfermedades de Notificación de la mujer embarazada. Los datos fueron analizados para exploración, descripción y análisis de consistencia. Resultados: La muestra estuvo compuesta en su mayoría por mujeres de 13 a 30 años, blancas y con instrucción básica incompleta. El control prenatal fue realizado por el 93,8% de las gestantes, siendo que el 66,1% conocía su estado serológico antes Del control prenatal y el 45% recibió notificación en el 1er trimestre. El acceso a la medicación antirretroviral ocurrió para el 82,4% de las mujeres embarazadas y para el 74,6% el resultado del embarazo fue nacido vivo. Las variables asociadas estadísticamente al control prenatal fueron evolución del embarazo, profilaxis antirretroviral, tipo de parto y antirretroviral al parto (p<0,001). Conclusión: Las gestantes de la muestra presentaron indicadores gestacionales deseados. Los datos recolectados permitieron describir el perfil de la muestra y evaluar El desempeño de la política de salud de las mujeres embarazadas.
RESUMO Objetivo: Descrever o perfil sociodemográfico e gestacional de mulheres HIV positivo de Curitiba-PR, anos 2018-2020. Método: Pesquisa observacional, transversal, com dados do Sistema de Informação de Agravos de notificação das gestantes. Os dados foram analisados para exploração de consistência, descrição e análise. Resultados: Amostra perfilou-se majoritariamente por mulheres brancas na faixa etária de 13-30 anos. Pré-natal foi realizado por 93,8% das gestantes, sendo que 66,1% sabiam sua condição sorológica antes do pré-natal e 45% receberam a notificação no 1º trimestre. O acesso à medicação antirretroviral ocorreu para 82,4% das gestantes e para 74,6% o desfecho da gestação foi bebê nascido vivo. As variáveis estatisticamente associadas ao pré-natal foram evolução da gravidez, profilaxia com antirretroviral, tipo de parto e antirretroviral no parto (p<0,001). Conclusão: As gestantes da amostra apresentaram indicadores gestacionais desejados. Os dados coletados permitiram descrever o perfil da amostra e avaliar o desempenho da política de saúde para gestantes.
RESUMO
The aim of this study was to perform a cross-cultural adaptation of the Brazilian version of the Dental Neglect Scale (DNS). The process included (i) Translation; ii) Synthesis; iii) Back translation; (iv) Critical analysis by a committee of experts; (v) Pilot studies (n1=30 + n2=30); and (6) Evaluation and refinement of the instrument. The validated DNS presented a Content Validity Index (CVI) equal to 1.0 for the total score, as well as for each item. In the pilot studies, a minimum agreement level of 80% in understanding was achieved. DNS was properly adapted for Brazilian Portuguese, and it needs further study in a representative sample for reliability and construct validity assessment.
Assuntos
Comparação Transcultural , Traduções , Brasil , Criança , Pré-Escolar , Humanos , Reprodutibilidade dos Testes , Inquéritos e QuestionáriosRESUMO
The organization of health systems in Health Care Networks (HCN) presents itself as a strategy to overcome the fragmentation of maternal and child health actions and services and to qualify care management. The objective of this study was to validate the Instrument for Evaluation of Maternal and Child Health Care Networks (IARAMI), adapted from the Evaluation Tool of Health Care Networks. The validation process comprised face and construct validation. The methodology used for face validation included the conceptual and semantic adaptation of the instrument and analysis by a panel of experts, through the modified consensus e-Delphi technique. After face validation, IARAMI was applied in a sample of 99 health managers of municipalities in the state of Paraná. The construct validation was conducted through the internal consistency analysis using Cronbach's alpha coefficient and factorial analysis. The factorial analysis technique was applied to each of the dimensions of the instrument, enabling the analysis of communalities. The results showed that IARAMI presented reliability and validity, proving to be a tool that can help managers and health workers in the planning, management, and evaluation of the degree of integration of the maternal and child care network.
A organização dos sistemas de saúde em redes de atenção à saúde (RAS) se apresenta como uma estratégia para superar a fragmentação das ações e serviços de saúde materno-infantil e qualificar a gestão do cuidado. O objetivo deste estudo foi validar o Instrumento de Avaliação de Redes de Atenção Materno-infantil (IARAMI), adaptado a partir do Instrumento de Avaliação de Redes de Atenção à Saúde. O processo de validação compreendeu a validação de face e construto. A metodologia utilizada para a validação de face incluiu a adaptação conceitual e semântica do instrumento e a análise por um painel de especialistas, por meio da técnica e-Delphi de consenso modificada. Após sua validação de face, o IARAMI foi aplicado em uma amostra de gestores de 99 municípios do estado do Paraná. A validação de construto foi conduzida por análise de consistência interna por meio do coeficiente alfa de Cronbach e de análise fatorial. A técnica de análise fatorial foi aplicada para cada uma das dimensões do instrumento, permitindo a análise de comunalidades. Os resultados evidenciaram que o IARAMI apresentou confiabilidade e validade, demonstrando ser uma ferramenta que pode auxiliar gestores e trabalhadores da saúde no planejamento, na gestão e na avaliação do grau de integração da rede de atenção à saúde materno-infantil.
Assuntos
Cuidado da Criança , Pessoal de Saúde , Brasil , Criança , Humanos , Psicometria , Reprodutibilidade dos Testes , Inquéritos e QuestionáriosRESUMO
BACKGROUND & AIMS: The symptoms of xerostomia and taste alteration are adverse effects which frequently occur in patients under chemotherapy and once associated they can potentially impair their nutritional status. The aim of this study was to investigate the association of xerostomia and taste alterations in patients being treated by neoplastic chemotherapy. METHODS: Fifty patients scheduled to receive neoplastic chemotherapy were followed for their first two chemotherapy cycles for solid tumors and the Chemotherapy-Induced Taste Alteration Scale (CiTAS) was adopted. Xerostomia was defined by the presence of dry mouth complaints reported by the patients and signs of hyposalivation identified during the intraoral examination. RESULTS: Of the 50 patients, 33 were women, mean age; 61,48 ± 9,07 years, and 17 were men, mean age; 57,35 ± 11,50 years. The most common tumor was located in the breast affecting 15 patients (30%). The Mann-Whitney test showed that the mean scores of CiTAS were significantly higher for those patients who reported having xerostomia when compared with those without xerostomia after the first two chemotherapy cycles. The cofounding variables such as age, smoking habits and use of antidepressants were not statistically associated with taste alterations (p > 0.05). CONCLUSIONS: Taste alterations were worse for patients who complained of xerostomia during the first two cycles of antineoplastic chemotherapy and the association of both symptoms can potentially impair their nutritional status and quality of life.
Assuntos
Antineoplásicos , Xerostomia , Antineoplásicos/efeitos adversos , Disgeusia/induzido quimicamente , Disgeusia/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Paladar , Xerostomia/induzido quimicamente , Xerostomia/epidemiologiaRESUMO
This study explores associated factors and perceptions of oral health among crack users recruited in open drug scenes in Brazil. A mixed methods approach was used. The quantitative component analysed findings from a large (N = 7381), population-based survey. The outcomes under analysis were 'self-perception of oral health' and 'self-reporting of problems affecting the mouth, teeth and gingiva (gums)'. The qualitative component comprised a focus group, with 12 individuals recruited from a drug treatment clinic. Lower self-perception of oral health problems vis-à-vis a higher prevalence of problems affecting the mouth, teeth, and gingiva were found in users who had a lower level of education, used substances daily, had worse self-perception of physical health, did not receive health care and regularly used alcohol and/or tobacco. The results show an association between substance use and decline in oral health, as well as the lack of health services focusing on such issues. Oral health services should be emphasised as a gateway to the health system. So far, the putative cross-referral between services and professionals working in oral health and other health professionals working in the field of drug dependence has not been observed.
Assuntos
Transtornos Relacionados ao Uso de Cocaína , Cocaína Crack , Brasil/epidemiologia , Humanos , Saúde Bucal , PercepçãoRESUMO
Early childhood caries (ECC) is a global problem, disproportionately affecting disadvantaged populations. The aim of this study was to evaluate systematically the available scientific evidence on the effectiveness of methods for ECC prevention. Six electronic databases were searched. Two independent reviewers selected the publications and analysed the quality of the included systematic reviews. Thirteen studies were included. Overall, eight reviews were classified with methodological quality critically low using the AMSTAR 2, whereas five reviews achieved a high risk of bias using the ROBIS tool. The methods identified that were positively related to the prevention of ECC were as follows: preventive dental programmes for pregnant women; advice on diet and feeding; prenatal oral health care; integration of maternal and children's oral health promotion into nursing practice; maternal oral health programmes undertaken by non-dental health professionals; dental health education in combination with the use of fluoride for children; early preventive dental visits; and the use of fluoride varnish and toothpastes with more than 1000 ppm of fluoride. The currently available evidence supporting the effectiveness of methods for prevention of ECC, although suggesting some methods of greater potential, is still lacking due to the methodological quality of the systematic reviews and the included primary studies.
Assuntos
Suscetibilidade à Cárie Dentária , Cárie Dentária , Criança , Pré-Escolar , Cárie Dentária/prevenção & controle , Feminino , Fluoretos , Humanos , Saúde Bucal , Gravidez , Cremes DentaisRESUMO
Abstract The aim of this study was to perform a cross-cultural adaptation of the Brazilian version of the Dental Neglect Scale (DNS). The process included (i) Translation; ii) Synthesis; iii) Back translation; (iv) Critical analysis by a committee of experts; (v) Pilot studies (n1=30 + n2=30); and (6) Evaluation and refinement of the instrument. The validated DNS presented a Content Validity Index (CVI) equal to 1.0 for the total score, as well as for each item. In the pilot studies, a minimum agreement level of 80% in understanding was achieved. DNS was properly adapted for Brazilian Portuguese, and it needs further study in a representative sample for reliability and construct validity assessment.
RESUMO
BACKGROUND: People with disabilities tend to have greater oral health problems compared to those without disabilities. This may be due to barriers they come across in accessing dental services. OBJECTIVES: The objective of this systematic review was to provide a critical digest of the scientific literature concerning barriers and facilitators of access to oral health services for people with disabilities. METHODS: The electronic databases PubMed, Scopus, Web of Science, Latin American and Caribbean Health Sciences Literature (LILACS), and Brazilian Library of Dentistry (BBO) were searched using keywords relevant to the subject. The search was not restricted to specific languages or years of publication; all relevant studies were translated and reviewed. RESULTS: Sixteen studies including 14 articles, a doctoral thesis, and a monograph were selected, and their quality was analysed using the Downs and Black assessment tool. Barriers to dental services were divided into physical or nonphysical based on the dentist's perspective, as per the perception of parents/guardians or by the persons with disabilities. The barriers that emerged included the dentist's lack of preparation to assist people with disabilities, structural problems of access to dental offices, communication difficulties, and lack of awareness regarding the need for dental treatment for the disabled person. CONCLUSION: It is concluded that people with disabilities continue to run into complex physical, behavioural, or multidimensional barriers in accessing dental services. Improved training of dentists for the care of this population is hereby emphasized. The legal framework enabling access to dental care for people with disabilities must also be respected in each country.
RESUMO
Este artigo apresenta os resultados de análise sobre a atenção secundária em saúde bucal na Rede de Atenção Materno-infantil em 136 municípios no estado do Paraná. Para avaliação do perfil dessa rede foi utilizado o Instrumento de Avaliação de Rede de Atenção Materno-infantil (IARAMI). Os participantes da pesquisa responderam a um questionário composto por 131 perguntas, sendo duas delas sobre saúde bucal. A organização da atenção secundária em saúde bucal foi identificada na maioria dos municípios avaliados (80,80%), porém falta integração com a atenção primária. Dos municípios avaliados apenas 13,13% apresentaram ótima integração entre esses pontos. A atenção à saúde bucal para gestantes e crianças deve ser organizada em redes de atenção integrada para garantir a qualificação da atenção. (AU)
This article presents the results of analysis of secondary care in oral health in the Maternal and Child Care Network in 136 municipalities in the state of Paraná. To evaluate the profile of this network, the Maternal and Child Care Network Assessment Instrument (IARAMI) was used. The participants answered a questionnaire consisting of 131 questions, two of them about oral health. The organization of secondary care in oral health was identified in most municipalities evaluated (80.80%), but there is notintegration with primary care. Of the municipalities evaluated, only 13.13% presented good integration between these points of attention. Oral health care for pregnant women and children should be organized into integrated care networks to ensure the qualification of care. (AU)
Assuntos
Atenção Secundária à Saúde , Cuidado da Criança , Saúde Bucal , Pesquisa , Inquéritos e QuestionáriosRESUMO
The profiles of polytraumatized patients in intensive care units were characterized. Serum and salivary markers were compared with normality between Classes I and II of APACHE II and between periods of hospitalization; these results were correlated. This was a prospective study on saliva charts and collection (n = 70). Profile: male, 27 years old, blunt traumas and collisions. Serum parameters with normality: decrease in pH, creatinine at admission to Class I, and at 48 and 72 hours in both classes; K+ at 48 h in Class II; Ca+ on admission in both classes and at 72 h in Class I. Increase in urea at 72 h in Class II, glucose at all times and in all classes, and Ca+ at 48 h in both classes. Class II had high Na+ at 48 and 72 h compared to Class I. In Class I, creatinine reduction occurred in 48 h and 72 h compared to admission and an increase of Ca+ at 48 h with admission. In Class II, pH and Na+ increased at 48 h and 72 h compared to admission. K+ decreased from admission to 48 h and increased from 48 h to 72 h. Urea increased from 48 to 72 hours. Creatinine decreased from admission to 48 and 72 hours. Ca+ increased from admission to 48 hours and decreased from 48 to 72 hours. There was an increase in the saliva levels in both classes and times in relation to normality. There was an increase in urea at admission, glucose at 72 h, and Ca+ at 48 h in Class II compared with Class I. Class I urea increased from admission to 48 h and Ca+ decreased from admission to 48 h. Class II urea decreased from 48 h to 72 h. Strong or very strong positive correlation was identified between blood and creatinine saliva at all times and regular and negative Ca+ at 72 h. This study provides evidence that salivary and serum biomarkers can be used together to monitor the evolution of the clinical symptoms of ICU patients.
Assuntos
Biomarcadores/sangue , Traumatismo Múltiplo/sangue , Ácido N-Acetilneuramínico/sangue , APACHE , Adolescente , Adulto , Idoso , Feminino , Hospitais Universitários , Humanos , Unidades de Terapia Intensiva , Masculino , Pessoa de Meia-Idade , Saliva/metabolismo , Adulto JovemRESUMO
INTRODUCTION: The epidemiological profile of dental caries for Indigenous Peoples is complex and heterogeneous. The oral health of the Kaingang people, third largest Indigenous population from Brazil, has not been investigated so far. OBJECTIVE: The purpose of this study was to assess the prevalence and severity of dental caries, in addition to the associated factors of the need of dental extraction among Kaingang adult Indigenous. METHODS: A cross-sectional oral health survey was conducted among Kaingang adults aged from 35 to 44 years old living in the Guarita Indigenous Land, Rio Grande do Sul. Clinical exams were performed to analyze the conditions of dental crown and treatment needs. RESULTS: A total of 107 Indigenous adults were examined. Mean DMFT score was 14.45 (± 5.80). Two-thirds of the DMFT score accounted for missing teeth. Anterior lower dentition presented the highest rates of sound teeth, whereas the lower first molars had the lowest. Need for dental extraction was observed in 34.58% and was associated with village location, time of last dental visit, and higher number of decayed teeth. CONCLUSION: The high frequencies of caries and missing teeth observed in this population indicate a lack of adequate assistance. It is essential to discuss health care models in order to combat avoidable social and health injustices.
Assuntos
Cárie Dentária/epidemiologia , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Indígenas Sul-Americanos/estatística & dados numéricos , Extração Dentária/estatística & dados numéricos , Adulto , Distribuição por Idade , Brasil/epidemiologia , Estudos Transversais , Índice CPO , Feminino , Humanos , Masculino , Prevalência , Índice de Gravidade de Doença , Distribuição por Sexo , Fatores Sociológicos , Estatísticas não ParamétricasRESUMO
Imprisoned women represent a growing population worldwide with important health needs. In this study, we aimed to analyze the impact of oral health conditions on the quality of life of female inmates in a maximum security correctional facility. Participants were examined and answered the OHIP-14 questionnaire. A total of 305 inmates were included in the study. Prevalence of untreated caries was 84%. Worse quality of life was associated with dental caries, dental pain, deep periodontal pocket, prosthetic use, and age. Sociodental indicators should be incorporated into healthcare and health policies in order to promote wellbeing among this vulnerable population.
Assuntos
Cárie Dentária/epidemiologia , Saúde Bucal/estatística & dados numéricos , Bolsa Periodontal/epidemiologia , Prisioneiros/estatística & dados numéricos , Adulto , Brasil/epidemiologia , Estudos Transversais , Feminino , Nível de Saúde , Humanos , Pessoa de Meia-Idade , Prevalência , Qualidade de Vida , Inquéritos e Questionários , Adulto JovemRESUMO
OBJECTIVES: To compare two different models of public oral health in primary care services, a so-called family health strategy (FHS), as opposed to non-FHS services designated as 'conventional' healthcare (CHC), regarding the presence and extent of the attributes of 'good' primary healthcare (PHC). The null hypothesis of this study is that the attributes do not differ between the FHS and CHC. DESIGN: Cross-sectional. SETTING: Public PHC services in Curitiba, the state capital of Paraná. PARTICIPANTS: PHC users of the public oral health network (n=900) and dentists active in this municipal network (n=203). PRIMARY AND SECONDARY OUTCOME MEASURES: The Primary Care Assessment Tool (PCATool)-Dentists and PCATool-Users were used to analyse the primary outcomes ('essential' attributes) and secondary outcomes ('derived' attributes) in the PHC. RESULTS: Overall, the primary care services in oral health were well evaluated, both by users and by dentists, with mean scores ascribed to PHC attributes mostly above the cut-off point (6.6). The exception for users were affiliation (6.36; 95% CI 6.11 to 6.60) and accessibility (5.83; 95% CI 5.78 to 5.89); and for dentists the accessibility (5.80; 95% CI 5.63 to 5.96). When comparing FHS and CHC, there was a superiority of the FHS model, which reached a general mean score of 7.53 (95% CI 7.48 to 7.58) among users and 7.56 (95% CI 7.45 to 7.67) among dentists; on the other hand, the CHC general mean score was of 6.61 (95% CI 6.49 to 6.73) and 6.68 (95% CI 6.56 to 6.80) respectively for users and dentists. CONCLUSIONS: The results reveal a reasonable level of attainment of PHC attributes in the services investigated. Nevertheless, public health managers should make efforts to reduce the difficulties faced by users in accessing dental care. The more positive results achieved by FHS services indicate that the provision of oral healthcare under this strategy should be expanded.
Assuntos
Assistência Odontológica/estatística & dados numéricos , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Atenção Primária à Saúde/estatística & dados numéricos , Qualidade da Assistência à Saúde/estatística & dados numéricos , Adulto , Brasil , Estudos Transversais , Feminino , Humanos , Masculino , Atenção Primária à Saúde/métodos , AutorrelatoRESUMO
INTRODUCTION: In Brazil, the undergraduate dental education still remains fragmented and dissociated from its social context, with emphasis on the individualistic and private aspects of dental health. This study aimed to analyze the training and development of university professors of dentistry in stricto sensu postgraduate programs in Brazil. MATERIALS AND METHODS: Delphi electronic methodology was used within a qualitative-quantitative design to gather data from a panel of 58 experts. Discussions representing the analytic axis focused on: (i) the evaluative processes of higher education, in particular stricto sensu postgraduate programs, and their influence on academic activities in undergraduate dentistry courses and (ii) policies for training and developing university professors. RESULTS: Of the experts, 30 participated in the first round, 24 in the second, and 19 in the third. They considered the training of university professors in dentistry to be highly specialized and technologically focused and indicated the review of political-pedagogic aspects of the educational sphere, as well as the social, economic, cultural, epidemiologic, and professional aspects of training and preparation prescribed by the National Curricular Guides for graduate courses in dentistry. An adequate process of evaluating the official organs and regulators of postgraduate stricto sensu programs, as well the programs themselves, should be implemented. CONCLUSION: The experts stated that changes to the university teaching system are necessary, even in the field of dentistry. Mechanisms for evaluating areas and professors were inadequate, and the training was overly specialized and not consistent with the social reality of the country.