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Background: This systematic review aimed to identify, describe, and analyze the global context of Atraumatic Restorative Treatment (ART) as public policy. Methods: The inclusion criteria were: studies on public oral health policies, dental caries, or ART. The exclusion criteria were: clinical studies, specific interventions unrelated to the decision making of managers or policymakers, studies that report public oral health policies that do not use ART as a strategy for caries treatment. A literature search was conducted in PubMed, BVS, Epistemonikos, Health Systems Evidence, and Rx for change. There were no language restrictions. Data extraction was performed by two authors independently according to the stages and categories of a conceptual framework and organized in spreadsheets using Microsoft Excel 365. Of the 2253 eligible articles, 139 were duplicates, and 1680 were not included after reviewing the title and abstract. After assessing the full text, 414 articles were excluded. Results: 20 articles were included in the current review. Nineteen were conducted in nine countries: South Africa (n = 3), Bolivia (n = 1), Cambodia (n = 2), Egypt (n = 2), Mexico (n = 2), Tanzania (n = 4), East Timor (n = 1), Tunisia (n = 1), and Zimbabwe (n = 3), and one in the Americas. Regarding local contexts, the studies reported a high prevalence of dental caries and a lack of access to restorative procedures in health services as common problems. Policy development processes were similar in some aspects, such as the presence of governments, conceptual use of scientific evidence, and induction by the World Health Organization. Regarding the barriers identified in the implementation stage, the lack of supplies to carry out the procedures and induction of the work process by managers were mentioned. As for the facilitators, permanent education and professional practice were mentioned. Cohort studies have shown promising results, with a survival rate greater than 80% after one year of follow up. Conclusions: The findings of this systematic review indicate that the use of ART in public policies is a promising option for tackling common problems in several countries, however, its use is still in an early stage.

The aim of this cross-sectional study was to assess whether favorable factors related to school characteristics have a positive effect on the impact of traumatic dental injury (TDI) on oral health-related quality of life (OHRQoL). An epidemiological survey of oral health was conducted with 12-year-old schoolchildren from Quito, Ecuador. Children were examined for TDI, dental caries, and malocclusion. Individual socioeconomic data were also collected. Information on the physical environment, health practices, and occurrence of negative episodes at school was collected from the school coordinators. The Child Perceptions Questionnaire 11-14 (CPQ11-14) was used to evaluate the OHRQoL (outcome variable). Multilevel Poisson regression analysis was conducted. Severe TDI was associated with higher CPQ11-14 scores, even in the multiple model adjusted for oral health conditions, sex, individual socioeconomic variables, and school-related variables. Children from schools that had an appropriate tooth-brushing environment for their students exhibited a lower impact on OHRQoL, even after adjustment for the occurrence of TDI and other variables. A favorable school environment may exert a positive effect on OHRQoL, independent of the occurrence of TDI.

The fuelling capacity of migratory birds and their ability to avoid health conditions derived from the subsequent fat overload are exceptional among vertebrates. In this work, we screen the expression of the genes involved in the production of ketone bodies (KB) in the liver of northern wheatears (Oenanthe oenanthe) during the development and resolution of migratory fattening. Thirteen genes were found to be regulated among the migratory stages. Based on the dynamics of gene expression, we concluded that KB play a versatile role in wheatears' energy metabolism homeostasis. The ketogenic pathway can adaptively: (i) provide carbon equivalents for lipogenesis, speeding up fuelling; (ii) replace glucose during long-distance flights using lipids as the substrate; (iii) act as a floodgate to avoid steatosis; and (iv) might provide a metabolic solution to defatting in captive birds.

The placenta is a remarkable organ that coordinates and regulates maternal-fetal interactions during pregnancy to optimize fetal development. A host of obstetric complications are associated with placental dysfunction, and existing methods for evaluating in vivo placental function fail to reliably detect at-risk pregnancies prior to maternal or fetal morbidity. Although routinely used as a monitoring tool, the predictive power of ultrasound for identifying compromised pregnancies is poor. Recent preclinical studies performed in our laboratory, using blood oxygen-level dependent magnetic resonance imaging (BOLD-MRI) in the pregnant nonhuman primate (NHP), established a strong correlation between placental T2* values and maternal-fetal oxygen transport. Here we extend this work to a large, longitudinal, two-site study of quantitative in vivo T2* mapping in human pregnancies across 11 to 38 weeks of gestation to characterize the evolution of placental oxygenation in uncomplicated pregnancies and to elucidate the relationship between aberrant placental T2* and adverse obstetric outcomes attributable to placental dysfunction. This methodology has high discriminatory power and strong potential diagnostic utility.

The liver plays a principal role in avian migration. Here, we characterised the liver transcriptome of a long-distance migrant, the Northern Wheatear (Oenanthe oenanthe), sampled at different migratory stages, looking for molecular processes linked with adaptations to migration. The analysis of the differentially expressed genes suggested changes in the periods of the circadian rhythm, variation in the proportion of cells in G1/S cell-cycle stages and the putative polyploidization of this cell population. This may explain the dramatic increment in the liver's metabolic capacities towards migration. Additionally, genes involved in anti-oxidative stress, detoxification and innate immune responses, lipid metabolism, inflammation and angiogenesis were regulated. Lipophagy and lipid catabolism were active at all migratory stages and increased towards the fattening and fat periods, explaining the relevance of lipolysis in controlling steatosis and maintaining liver health. Our study clears the way for future functional studies regarding long-distance avian migration.

Purpose: To assess whether favourable factors related to school characteristics have a positive effect on the impact on OHRQoL related to occurrence TDI.Methods: An epidemiological survey of oral health was conducted with 12-year-old scholars from Quito, Ecuador. Children were examined regarding TDI, dental caries, and malocclusion. Individual socioeconomic data was collected. Information on the physical environment, health practices and occurrence of negative episodes in the schools were collected with the school’s coordinators. The Child Perceptions Questionnaire 11-14 (CPQ11-14) was answered to evaluate the OHRQoL (outcome variable). Multilevel Poisson regression analysis was conducted. Results: Occurrence of severe TDI was associated with higher CPQ11-14 scores, even in the multiple model adjusted for oral health conditions, sex, individual socioeconomic variables, and school-related variables. Children from schools that had an appropriate tooth brushing environment for their students exhibited a lower impact on OHRQoL, even when adjusted for occurrence of TDI and other variables. Conclusion: A favourable school environment may exert a positive effect on the OHRQoL, independently of the occurrence of TDI.

Robust epidemiological data allow for logical interventions taken in the interest of public health. Dental caries is a major public health problem driven by increased sugar consumption and various biological, behavioral, and psychosocial factors, and is known to strongly affect an individual’s quality of life. This study aims to critically review epidemiological data on the prevalence of dental caries in Latin American and Caribbean countries (LACC) and its impact on the oral health-related quality of life (OHRQoL) of the population. Although the majority of national surveys did not include all age groups and several countries reported a reduction in the prevalence of cavitated carious lesions, most nations still exhibited a high burden of decayed teeth. OHRQoL evaluation was limited to children and older adults only, and was not included in any national survey. Study heterogeneity and methodological issues hindered comparison of evidence between studies and over time, and updating national level data on caries prevalence and its impact on OHRQoL should be prioritized in LACCs.

This work presents an updated and more complete version of the transcriptome of a long-distance migrant, the Northern Wheatear (Oenanthe oenanthe). The improved transcriptome was produced from the independent mRNA sequencing of adipose tissue, brain, intestines, liver, skin, and muscle tissues sampled during the autumnal migratory season. This new transcriptome has better sequencing coverage and is more representative of the species’ migratory phenotype. We assembled 20,248 transcripts grouped into 16,430 genes, from which 78% were successfully annotated. All the standard assembly quality parameters were improved in the second transcriptome version.

To analyze the association between the coverage by oral health teams in the Family Health Strategy (FHS-OH) and the use of dental services among 12-year-old adolescents in the state of Mato Grosso do Sul, Brazil, 2019.This is a cross-sectional study involving school-based research, which adopted the use of dental services as its outcome. Structural equation modeling was used to test the association between covariates and the outcome.Of the 615 participants, 74.0% used dental services in the last three years. ESF-SB (oral health coverage by family health strategy, acronym in Portuguese) ≥50% was associated with a greater use of public dental services [standardized coefficient (SC) = 0.10 -95%CI 0.01;0.18], a lower use of these services for prevention (SC = -0.07 -95%CI -0.17;0.01) and higher unhealthy food consumption (SC = 0.19 -95%CI 0.11;0.26).Higher ESF-SB coverage was associated with a lower use of dental services for prevention and higher unhealthy food consumption. Teams must organize the access to oral health service and qualify the work process.Analisar a associação entre a cobertura de equipes de saúde bucal na Estratégia Saúde da Família (ESF-SB) e a utilização de serviços odontológicos entre adolescentes de 12 anos, em Mato Grosso do Sul, Brasil, 2019.Trata-se de um estudo transversal, cujo desfecho foi a utilização de serviços odontológicos. Modelos de equações estruturais foram construídos para testar a associação das covariáveis com o desfecho.Dos 615 participantes, 74,0% utilizaram os serviços odontológicos nos últimos três anos. A cobertura de ESF-SB ≥50% associou-se a maior uso de serviços públicos [coeficiente padronizado (CP) = 0,10 - IC95% 0,01;0,18], menor uso para prevenção (CP = -0,07 - IC95% -0,17;0,01) e maior consumo de alimentos não saudáveis (CP = 0,19 - IC95% 0,11;0,26).Maiores coberturas de ESF-SB associaram-se a menor utilização de serviços para prevenção e maior consumo alimentar não saudável. As equipes devem organizar o acesso e qualificar o processo de trabalho.Analizar la asociación entre la cobertura de los equipos de salud bucal en la Estrategia Salud de la Familia (ESF-SB) y el uso de servicios odontológicos en 12 años en Mato Grosso do Sul, 2019.Este es un estudio transversal. El resultado fue el uso de servicios dentales. Se realizaron modelos de ecuaciones estructurales para asociación de covariables con el resultado.De los 615 participantes, el 74,0% utilizó servicios dentales en los últimos tres años. La cobertura de ESF-SB ≥50% se asoció con mayor uso público [coeficiente estandarizado (CE) = 0,10 - IC95% 0,01;0,18], menor uso para prevención (CE = -0,07 - IC95% -0,17;0,01) y mayor consumo de alimentos no saludables (CE = 0,19 - IC95% 0,11;0,26).Mayor cobertura de ESF-SB se asoció con un menor uso para la prevención y un mayor consumo de alimentos no saludables. Los equipos de salud bucal deben organizar el proceso de trabajo.

Resumo Objetivo Analisar a associação entre a cobertura de equipes de saúde bucal na Estratégia Saúde da Família (ESF-SB) e a utilização de serviços odontológicos entre adolescentes de 12 anos, em Mato Grosso do Sul, Brasil, 2019. Métodos Trata-se de um estudo transversal, cujo desfecho foi a utilização de serviços odontológicos. Modelos de equações estruturais foram construídos para testar a associação das covariáveis com o desfecho. Resultados Dos 615 participantes, 74,0% utilizaram os serviços odontológicos nos últimos três anos. A cobertura de ESF-SB ≥50% associou-se a maior uso de serviços públicos [coeficiente padronizado (CP) = 0,10 - IC95% 0,01;0,18], menor uso para prevenção (CP = -0,07 - IC95% -0,17;0,01) e maior consumo de alimentos não saudáveis (CP = 0,19 - IC95% 0,11;0,26). Conclusão Maiores coberturas de ESF-SB associaram-se a menor utilização de serviços para prevenção e maior consumo alimentar não saudável. As equipes devem organizar o acesso e qualificar o processo de trabalho. Resumen Objetivo Analizar la asociación entre la cobertura de los equipos de salud bucal en la Estrategia Salud de la Familia (ESF-SB) y el uso de servicios odontológicos en 12 años en Mato Grosso do Sul, 2019. Métodos Este es un estudio transversal. El resultado fue el uso de servicios dentales. Se realizaron modelos de ecuaciones estructurales para asociación de covariables con el resultado. Resultados De los 615 participantes, el 74,0% utilizó servicios dentales en los últimos tres años. La cobertura de ESF-SB ≥50% se asoció con mayor uso público [coeficiente estandarizado (CE) = 0,10 - IC95% 0,01;0,18], menor uso para prevención (CE = -0,07 - IC95% -0,17;0,01) y mayor consumo de alimentos no saludables (CE = 0,19 - IC95% 0,11;0,26). Conclusión Mayor cobertura de ESF-SB se asoció con un menor uso para la prevención y un mayor consumo de alimentos no saludables. Los equipos de salud bucal deben organizar el proceso de trabajo. Abstract Objective To analyze the association between the coverage by oral health teams in the Family Health Strategy (FHS-OH) and the use of dental services among 12-year-old adolescents in the state of Mato Grosso do Sul, Brazil, 2019. Methods This is a cross-sectional study involving school-based research, which adopted the use of dental services as its outcome. Structural equation modeling was used to test the association between covariates and the outcome. Results Of the 615 participants, 74.0% used dental services in the last three years. ESF-SB (oral health coverage by family health strategy, acronym in Portuguese) ≥50% was associated with a greater use of public dental services [standardized coefficient (SC) = 0.10 -95%CI 0.01;0.18], a lower use of these services for prevention (SC = -0.07 -95%CI -0.17;0.01) and higher unhealthy food consumption (SC = 0.19 -95%CI 0.11;0.26). Conclusion Higher ESF-SB coverage was associated with a lower use of dental services for prevention and higher unhealthy food consumption. Teams must organize the access to oral health service and qualify the work process.

RESUMO: Objetivo: Verificar a associação entre impacto nas atividades de vida diária e variáveis sociodemográficas e parâmetros bucais em adolescentes no Estado de São Paulo. Métodos: Estudo transversal com dados de 5.409 adolescentes que participaram da “Pesquisa Estadual de Saúde Bucal de São Paulo - SB”, de 2015. O impacto nas atividades de vida diária foi avaliado pelo índice de impacto das condições de saúde bucal nas atividades de vida diária (em inglês: oral impacts on daily performances [OIDP]), pela prevalência (presença ou ausência de impacto) e pela severidade do impacto (escores do OIDP). Utilizou-se o modelo de regressão binomial negativa inflado de zeros, considerando os pesos amostrais. Foram calculados as razões de prevalências (RP), as razões de médias (RM) e os intervalos de confiança (IC). Resultados: A prevalência de impacto nas atividades de vida diária foi de 37,4%. Após o ajuste, pôde-se observar que o sexo feminino permaneceu com maior prevalência (RP = 1,59; IC95% 1,36 ‒ 1,81) e severidade do impacto (RM = 1,49; IC95% 1,22 ‒ 1,81). Na comparação com brancos, os demais grupos tiveram maior prevalência de impacto. A renda familiar maior que R$ 2.501 (RM = 0,79; IC95% 0,64 ‒ 0,98) e a aglomeração domiciliar (RM = 1,18; IC95% 1,00 ‒ 1,39) foram associadas com a severidade do impacto. Nas condições de saúde bucal, verificou-se que a cárie não tratada (RP = 1,46; IC95% 1,23 ‒ 1,74) e o sangramento gengival (RP = 1,35; IC95% 1,14 ‒ 1,60) permaneceram associados com maior prevalência de impacto. Conclusão: Sexo feminino, ter cor não branca, ter cárie não tratada e sangramento gengival foram associados ao maior impacto nas atividades de vida diária. Ter renda maior que R$ 2.500 e residir em domicílios menos aglomerados associaram-se com menor impacto. ABSTRACT: Objective: To assess the association between the impact of oral health on daily life and sociodemographic variables with oral parameters in adolescents living in the State of São Paulo, Brazil. Methods: A cross-sectional study was conducted with data from 5,409 adolescents who participated in the “State Oral Health Survey of São Paulo - OH”, 2015. The impact of oral health on daily life was assessed by the oral impacts on daily performances (OIDP) index, prevalence (presence or absence of impact) and severity of impact (OIDP scores). The negative binomial regression model (zeros-inflated) was used, considering the complex sampling and the sample weights. Prevalence ratio (PR), ratio of means (ROM) and confidence intervals (CI) were calculated. Results: The prevalence of impact was 37.4%. After adjusting for the model, the impact was more prevalent (PR = 1.59; 95%CI 1.22 ‒ 1.81) and more severe (RR = 1.49; 95%CI 1.22 ‒ 1.81) among females. Compared to white-skin people, all remaining groups had a higher prevalence of impact. Among socioeconomic characteristics, family income higher than R$ 2,501 (RR = 0.79; 95%CI 0.64 ‒ 0.98) and household crowding (RR = 1.18; 95%CI 1.00 ‒ 1.39) were associated with the severity of impact. In the oral health conditions, untreated caries (PR = 1.46; 95%CI 1.23 ‒ 1.74) and gingival bleeding (PR = 1.35; 95%CI 1.14 ‒ 1.60) were associated with higher prevalence of impact. Conclusion: Females, non-whites, with untreated caries and gingival bleeding were associated with higher impact of oral health on daily life. Family income higher than R$ 2,500 and living in less crowded households were factors associated with less impact.

Resumo Objetivo: Analisar a associação entre prevalência e severidade da cárie e fatores demográficos e socioeconômicos, comportamental e de condições de saúde bucal em adolescentes. Métodos: Estudo transversal com dados secundários de 5.558 adolescentes (15 a 19 anos) examinados na Pesquisa Estadual de Saúde Bucal de São Paulo em 2015. As associações foram testadas pelo modelo de regressão binomial negativa inflado de zeros, considerando-se os pesos amostrais. estimaram-se as razões de prevalência (RP), razões de média (RM) e intervalos de confiança (IC). Resultados: A prevalência de cárie foi de 71,7%, maior no gênero feminino (RP=1,09 - IC95% 1,04;1,15), associada a atraso escolar (RP=1,11 - IC95% 1,03;1,18), cálculo dentário (RP=1,10 - IC95% 1,01;1,20) e não acesso à água fluoretada (RP=1,21 - IC95% 1,01;1,45). Conclusão: A identificação dos fatores associados à cárie pode instruir a programação dos serviços de saúde dirigidos ao controle da doença. Resumen Objetivo: Analizar la asociación entre prevalencia y magnitud de la caries y factores demográficos, socioeconómicos, conductuales y de salud bucal en adolescentes. Métodos: Estudio transversal con datos secundarios de 5.558 adolescentes (15 a 19 años) examinados en la Encuesta de Salud Oral del Estado de São Paulo en 2015. Las asociaciones se probaron mediante el modelo de regresión binomial negativa inflado de ceros, considerando los pesos de la muestra. Se estimaron las razones de prevalencia (RP), razones medias (RM) e intervalos de confianza (IC). Resultados: La prevalencia de caries fue del 71,7% y mayor en las mujeres (PR=1,09 y IC95% 1,04;1,15), asociada a atraso escolar (PR=1.11 - IC95% 1,03;1,18), cálculo dental (PR=1,10 - IC95% 1,01;1,20) y sin acceso a agua fluorada (PR=1,21 - IC95% 1,01;1,45). Conclusión: La identificación de los factores asociados con la caries puede instruir la programación de servicios de salud destinados a controlar enfermedad. Abstract Objective: To analyze association between prevalence and severity of dental caries and demographic, socioeconomic, behavioral and oral health status in adolescents. Methods: This was a cross-sectional study with secondary data on 5,558 adolescents examined in the São Paulo State Oral Health Survey in 2015. The zero-inflated negative binomial regression model was used, considering sample weights. Prevalence ratios (PR), ratios of mean (RM) and confidence intervals (CI) were estimated. Results: Caries prevalence was 71.7%, and was higher in females (PR=1.09 - 95%CI 1.04;1.15), associated with being behind at school (PR=1.11 - 95%CI 1.03;1.18), dental calculus (PR=1.10 - 95%CI 1.01;1.20) and no access to fluoridated water (PR=1.21 - 95%CI 1.01;1.45). Conclusion: Identification of factors associated with dental caries can instruct the programming of health services aimed at controlling the disease.

This study aimed to identify factors associated with the need for complete dentures in one dental arch or both, among the elderly population. The cross-sectional household study was conducted with a representative sample of elderly people (65 years or older) in the state of São Paulo, Brazil, in 2015. The dependent variable was the need for complete dentures (in one arch or both), and independent variables were socioeconomic and demographic conditions, social capital, self-perception of oral health and access to dental services. Simple and multinomial logistic regression models tested effect measures (p < 0.05). A total of 5,948 elderly people participated. Results indicated that those with greater chances of needing a complete denture in one arch were male (OR = 1.54; CI95%:1.04–2.29), with fewer household goods (OR = 2.25; CI95%:1.50–3.38), lower monthly household income: R$501-1500 (OR = 3.44; CI95%:1.27–9.35), R$1501–2500 (OR = 4.11; CI95%:1.50–11.27), R$2501–4500 (OR = 2.76; CI95%:1.10–6.95), self-reported need for a complete denture (OR = 4.75; CI95%:3.08–7.35), ≥3 years since last dental appointment (OR = 1.80; CI95%:1.06–3.05), and dissatisfaction with last dental appointment (OR = 1.80; CI95%:1.06–3.05). There were more chances of the need for complete dentures in both arches among older elders (OR = 1.44; CI95%:1.06–1.88), with lower monthly household income: R$ < 501 (OR = 4.45; CI95%:1.71–11.60), R$501–1500 (OR = 4.01; CI95%:2.14–7.51), R$1501–2500 (OR = 2.95; CI95%:1.64–5.32), < 3 years of education (OR = 1.45; CI95%:1.13–1.85), feeling unhappy (OR = 2.74; CI95%:1.35–5.57), self-reported need for a complete denture (OR = 8.48; CI95%:5.75–12.50), dissatisfaction with their mouth (OR = 2.38; CI95%:1.64–3.46), ≥3 years since last dental appointment (OR = 4.28; CI95%:2.85–6.43), and dissatisfaction with last dental appointment (OR = 4.28; CI95%:2.85–6.43). The several dimensions of the determinants of the need for a complete denture reflect the influence of both demographic and socioeconomic aspects, social capital, self-perception of oral health and access to dental services.

To analyze association between prevalence and severity of dental caries and demographic, socioeconomic, behavioral and oral health status in adolescents.This was a cross-sectional study with secondary data on 5,558 adolescents examined in the São Paulo State Oral Health Survey in 2015. The zero-inflated negative binomial regression model was used, considering sample weights. Prevalence ratios (PR), ratios of mean (RM) and confidence intervals (CI) were estimated.Caries prevalence was 71.7%, and was higher in females (PR=1.09 - 95%CI 1.04;1.15), associated with being behind at school (PR=1.11 - 95%CI 1.03;1.18), dental calculus (PR=1.10 - 95%CI 1.01;1.20) and no access to fluoridated water (PR=1.21 - 95%CI 1.01;1.45).Identification of factors associated with dental caries can instruct the programming of health services aimed at controlling the disease.Analisar a associação entre prevalência e severidade da cárie e fatores demográficos e socioeconômicos, comportamental e de condições de saúde bucal em adolescentes.Estudo transversal com dados secundários de 5.558 adolescentes (15 a 19 anos) examinados na Pesquisa Estadual de Saúde Bucal de São Paulo em 2015. As associações foram testadas pelo modelo de regressão binomial negativa inflado de zeros, considerando-se os pesos amostrais. estimaram-se as razões de prevalência (RP), razões de média (RM) e intervalos de confiança (IC).A prevalência de cárie foi de 71,7%, maior no gênero feminino (RP=1,09 - IC95% 1,04;1,15), associada a atraso escolar (RP=1,11 - IC95% 1,03;1,18), cálculo dentário (RP=1,10 - IC95% 1,01;1,20) e não acesso à água fluoretada (RP=1,21 - IC95% 1,01;1,45).A identificação dos fatores associados à cárie pode instruir a programação dos serviços de saúde dirigidos ao controle da doença.Analizar la asociación entre prevalencia y magnitud de la caries y factores demográficos, socioeconómicos, conductuales y de salud bucal en adolescentes.Estudio transversal con datos secundarios de 5.558 adolescentes (15 a 19 años) examinados en la Encuesta de Salud Oral del Estado de São Paulo en 2015. Las asociaciones se probaron mediante el modelo de regresión binomial negativa inflado de ceros, considerando los pesos de la muestra. Se estimaron las razones de prevalencia (RP), razones medias (RM) e intervalos de confianza (IC).La prevalencia de caries fue del 71,7% y mayor en las mujeres (PR=1,09 y IC95% 1,04;1,15), asociada a atraso escolar (PR=1.11 - IC95% 1,03;1,18), cálculo dental (PR=1,10 - IC95% 1,01;1,20) y sin acceso a agua fluorada (PR=1,21 - IC95% 1,01;1,45).La identificación de los factores asociados con la caries puede instruir la programación de servicios de salud destinados a controlar enfermedad.

To assess the association between the impact of oral health on daily life and sociodemographic variables with oral parameters in adolescents living in the State of São Paulo, Brazil.A cross-sectional study was conducted with data from 5,409 adolescents who participated in the "State Oral Health Survey of São Paulo - OH", 2015. The impact of oral health on daily life was assessed by the oral impacts on daily performances (OIDP) index, prevalence (presence or absence of impact) and severity of impact (OIDP scores). The negative binomial regression model (zeros-inflated) was used, considering the complex sampling and the sample weights. Prevalence ratio (PR), ratio of means (ROM) and confidence intervals (CI) were calculated.The prevalence of impact was 37.4%. After adjusting for the model, the impact was more prevalent (PR = 1.59; 95%CI 1.22 ‒ 1.81) and more severe (RR = 1.49; 95%CI 1.22 ‒ 1.81) among females. Compared to white-skin people, all remaining groups had a higher prevalence of impact. Among socioeconomic characteristics, family income higher than R$ 2,501 (RR = 0.79; 95%CI 0.64 ‒ 0.98) and household crowding (RR = 1.18; 95%CI 1.00 ‒ 1.39) were associated with the severity of impact. In the oral health conditions, untreated caries (PR = 1.46; 95%CI 1.23 ‒ 1.74) and gingival bleeding (PR = 1.35; 95%CI 1.14 ‒ 1.60) were associated with higher prevalence of impact.Females, non-whites, with untreated caries and gingival bleeding were associated with higher impact of oral health on daily life. Family income higher than R$ 2,500 and living in less crowded households were factors associated with less impact.Verificar a associação entre impacto nas atividades de vida diária e variáveis sociodemográficas e parâmetros bucais em adolescentes no Estado de São Paulo.Estudo transversal com dados de 5.409 adolescentes que participaram da “Pesquisa Estadual de Saúde Bucal de São Paulo - SB”, de 2015. O impacto nas atividades de vida diária foi avaliado pelo índice de impacto das condições de saúde bucal nas atividades de vida diária (em inglês: oral impacts on daily performances [OIDP]), pela prevalência (presença ou ausência de impacto) e pela severidade do impacto (escores do OIDP). Utilizou-se o modelo de regressão binomial negativa inflado de zeros, considerando os pesos amostrais. Foram calculados as razões de prevalências (RP), as razões de médias (RM) e os intervalos de confiança (IC).A prevalência de impacto nas atividades de vida diária foi de 37,4%. Após o ajuste, pôde-se observar que o sexo feminino permaneceu com maior prevalência (RP = 1,59; IC95% 1,36 ‒ 1,81) e severidade do impacto (RM = 1,49; IC95% 1,22 ‒ 1,81). Na comparação com brancos, os demais grupos tiveram maior prevalência de impacto. A renda familiar maior que R$ 2.501 (RM = 0,79; IC95% 0,64 ‒ 0,98) e a aglomeração domiciliar (RM = 1,18; IC95% 1,00 ‒ 1,39) foram associadas com a severidade do impacto. Nas condições de saúde bucal, verificou-se que a cárie não tratada (RP = 1,46; IC95% 1,23 ‒ 1,74) e o sangramento gengival (RP = 1,35; IC95% 1,14 ‒ 1,60) permaneceram associados com maior prevalência de impacto.Sexo feminino, ter cor não branca, ter cárie não tratada e sangramento gengival foram associados ao maior impacto nas atividades de vida diária. Ter renda maior que R$ 2.500 e residir em domicílios menos aglomerados associaram-se com menor impacto.

Objetivo: Analisar os fatores associados ao tipo de serviço odontológico utilizado por adultos. Métodos: O estudo transversal analítico utilizou-se de dados secundários do Levantamento Epidemiológico representativo da população adulta (35-44 anos) no município de Embu das Artes-SP, Brasil, em 2008. A coleta de dados por amostragem probabilística foi realizada nos domicílios. O desfecho foi ser usuário do serviço público odontológico para tratamento regular ou atendimento de urgência. As variáveis independentes foram: agravos bucais (Índice de dentes Permanentes Cariados, Perdidos e Obturados, Índice Periodontal Comunitário, Perda de Inserção Periodontal e necessidade de prótese); condições socioeconômicas (renda familiar, aglomeração domiciliar, número de filhos, escolaridade); condições demográficas (sexo, estado civil, cor da pele); hábitos (fumo); utilização dos serviços (tempo da última consulta odontológica, informações sobre como evitar problemas bucais); percepção dos problemas bucais (dor de dente nos últimos seis meses, necessidade de tratamento e condição bucal afeta relacionamentos com outras pessoas). Houve realização de análise descritiva e bivariada, além das razões de prevalência (RP). Resultados: Houve a participação de 345 adultos, sendo 53% usuários do serviço público para tratamento regular ou urgência odontológica. O uso regular ou de urgência odontológico público foi associado ao sexo feminino (RP = 1,32; IC95%: 1,14-1,54), ter maior número de filhos (RP = 1,15; IC95%: 1,01-1,31), aglomeração domiciliar (RP = 1,88; IC95%: 1,42-2,50), menor renda familiar (RP = 2,23; IC95%: 1,33- 3,66), relato de dor nos últimos 6 meses (RP = 1,43; IC95%: 1,06-1,42), considerar que a condição bucal afeta os relacionamentos com outras pessoas (RP = 1,30; IC95%: 1,05-1,62), e ser fumante ou ex fumante (RP = 1,67; IC95%: 1,15-2,24). O uso do serviço público apenas para o tratamento de urgência foi maior entre mulheres (RP = 1,48; IC95%: 1,16-1,86), maior número de filhos (RP = 1,22; IC95%: 1,08-1,37), aglomeração domiciliar (RP: 1,54; IC95%: 1,20-1,97), menor renda familiar (RP = 1,68; IC95%: 1,07-2,62) e apresentar relato de dor nos últimos seis meses (RP = 1,37; IC95%: 1,03-1,83). Conclusão: O uso do serviço odontológico público esteve associado a fatores socioeconômicos, e isso demonstra que, mesmo há 10 anos, o município praticava o princípio da equidade na atenção à saúde bucal. Descritores: Acesso aos serviços de saúde. Odontologia em saúde pública. Serviços de saúde bucal.

The fuelling capacity of migratory birds and their ability to avoid health conditions derived from the subsequent fat overload are exceptional among vertebrates. In this work, we screen the expression of the genes involved in the production of ketone bodies (KB) in the liver of northern wheatears (Oenanthe oenanthe) during the development and resolution of migratory fattening. Thirteen genes were found to be regulated among the migratory stages. Based on the dynamics of gene expression, we concluded that KB play a versatile role in wheatears' energy metabolism homeostasis. The ketogenic pathway can adaptively: (i) provide carbon equivalents for lipogenesis, speeding up fuelling; (ii) replace glucose during long-distance flights using lipids as the substrate; (iii) act as a floodgate to avoid steatosis; and (iv) might provide a metabolic solution to defatting in captive birds.

O trabalho objetivou descrever e qualificar o acesso a computadores e à rede de internet, bem como ao ambiente virtual de aprendizagem (AVA) e suas respectivas ferramentas, por graduandos da Faculdade de Odontologia da Universidade de São Paulo. Estudo transversal, baseado em questionários aplicados em um universo de 715 estudantes, os quais estivessem presentes nas salas de aula das onze turmas dos diferentes anos e turnos. Foram feitas análises de distribuição de frequência e teste de associação no programa EPI-Info v.6.0, medidas pela Razão de Chances (OR - odds ratio). Todos os respondentes (n=400) possuem computador em casa, 98% com acesso à internet e 84,5% utilizam os computadores disponibilizados pela Instituição. Majoritariamente (89,7%), os alunos dedicaram mais de duas horas semanais para atividades virtuais. Observou-se que os alunos do noturno apresentaram duas vezes mais chances de utilização de computador que alunos do integral. Ao menos uma disciplina que utiliza o AVA (Plataforma Moodle) foi identificada por 96,5% dos estudantes. Ao acessar o AVA, os alunos declararam ter maior facilidade para acessar a página inicial e os textos disponibilizados. Fóruns e chats foram apontados como ações de menor facilidade de execução. Não houve associação entre o tempo de uso do computador e a avaliação da utilização das ferramentas. Infraestrutura computacional que acompanhe os avanços tecnológicos e a utilização de um AVA com ferramentas acessíveis podem potencializar a incorporação da educação online.

The design of an electronically steerable wideband planar traveling-wave antenna is presented. The proposed antenna has a very simple structure based on a microstrip line loaded with several radiating elements and phase shifters between them. The phase shifters are based on tunable capacitances, in order to perform a continuous phase shift between the radiating elements and control the main beam direction. The radiating elements are complementary strip slots that have a very broad impedance bandwidth, thus allowing the antenna to have two different modes of operation: maintaining the main lobe direction over a significant bandwidth, 1.71–2.17 GHz, and performing a main beam scanning over this bandwidth with a maximum angle range of $-45^{\circ}$ to 45° at 2 GHz.

Revealing the genetic population structure in abundant avian species is crucial for understanding speciation, conservation, and evolutionary history. The Red-backed Shrike Lanius collurio, an iconic songbird renowned for impaling its prey, is widely distributed as a breeder across much of Europe, Asia Minor and western Asia. However, in recent decades, many populations have declined significantly, as a result of habitat loss, hunting along migration routes, decrease of arthropod food, and climate change e.g., severe droughts in Africa. Within this context, gene flow among different breeding populations becomes critical to ensure the survival of the species, but we still lack an overview on the genetic diversity of the species. In this paper, we analyzed the mitochondrial cytochrome b gene (mtDNA) and the cytochrome c oxidase subunit 1 gene (mtDNA) of 132 breeding Red-backed Shrikes from across the entire breeding range to address this knowledge gap. Our results revealed consistent genetic diversity and 76 haplotypes among the Eurasian populations. Birds are clustered in two major groups, with no clear geographical separation, as a direct consequence of Pleistocene glaciations and apparent lineage mixing in refugia. This has led to genetic panmixia.

OBJECTIVE To evaluate the association of school failure among Brazilian adolescents with social conditions and aspects of oral health through hierarchical analysis. METHODS A state-wide survey of 5,558 adolescents from the state of São Paulo, Brazil, inquired about the sociodemographic and social capital of participants by using a structured questionnaire. Trained and calibrated professionals performed intraoral examinations and interviews in the households. Questions about the access to dentist, reason for and frequency of using dental services, toothache episodes and impact of oral conditions on daily activities (OIDP) were applied. Oral examinations evaluated caries experience, tooth losses, periodontal problems, presence of open bite, and maxillary and mandibular overjet. School failure was estimated according to the teenagers’ years of schooling. The independent variables were grouped into three blocks: sociodemographic and economic characteristics, social capital and oral health aspects. The multiple hierarchical logistic regression model was used to identify the factors associated with school failure. RESULTS Of the total sample, information about schooling of 5,162 adolescents was obtained, of whom 29.6% presented school failure. We found that adolescents over the age of 16 years who did not declare themselves as white, female, with feelings of insecurity, unhappiness, with toothache, caries, tooth losses, affected by dentofacial and/or periodontal changes, were more likely to fail at school. CONCLUSION Oral disorders and social factors were associated with school failure in adolescents. A successful school trajectory was a strong determinant of health, therefore actions between the educational and health sectors must be developed for adolescents, especially those with this profile.

The objective of this study was to investigate the experience of caries related to social capital and associated factors in adults in large-scale population-based study. A Cross-sectional study was performed in 163 municipalities in the State of São Paulo, Brazil (SBSP-2015). 17,560 people were evaluated, of which 6051 were adults aged 35–44 years. Hierarchical logistic regression analysis was proposed. Outcome variables (decayed teeth, missing teeth and DMFT) and independent variables were included in the model, considering the distal (income and schooling); intermediate (social capital) and proximal levels (sex and ethnicity). Results showed that income up to 1,500 reais – US$ 367.6 in 11/11/2019 - (OR = 1.91;1.75–2.08), schooling up to 8 years (OR = 1.32;1.12–1.56) and non-white ethnicity (OR = 1.54;1.35–1.76) were more likely to have decayed teeth. Income up to 1500 reais (OR = 1.29;1.15-1.44), schooling up to 8 years (OR = 2.13;1.90–2.38), low social capital (OR = 1.84;1.65–2.04), medium social capital (OR = 1.15;1.01–1.30) and females were more likely to have lost teeth (OR = 1.13;1.03–1.23). Schooling up to 8 years (OR = 1.51;1.35–1.69), low social capital (OR = 1.25; 1.14–1.37) and female (OR = 1.40,1.19–1.53) were associated with DMFT. It was concluded that sociodemographic factors and low social capital were associated with the experience of caries, which should be taken into account in the formulation of public policies.

OBJECTIVE To evaluate the factors associated with tooth loss in adults from the position and number of teeth lost in the dental arches. METHODS This is a cross-sectional, population-based study with adults participating in the epidemiological survey of oral health of São Paulo in 2015. The outcome of the study was tooth loss, assessed by the proposed classification, namely: I) lost up to 12 back teeth; II) lost up to 12 teeth (including front teeth); and III) lost more than 12 teeth. A four-block analysis was conducted, supported by a conceptual theoretical model adapted for tooth loss. For the multinomial logistic regression, “individuals who did not lose teeth due to caries or periodontal disease” was used as reference (p < 0.05). RESULTS Of 6,051 adults evaluated, 25.3% (n = 1,530) were classified in category I, 32.7% (n = 1,977) in II, 9.4% (n = 568) in III, and 1.9% (n = 117) were edentulous. Lower income and schooling, the perception of need for treatment and the last appointment motivated by routine, pain or extraction were associated with tooth loss, regardless of the classification. The negative evaluation of the dental service was associated with individuals who lost up to 12 teeth, both front and back. The presence of women and periodontal pocket were associated with tooth loss of up to 12 teeth, including front, and more than 12 teeth. Caries were associated with adults who lost up to 12 teeth, including front teeth. CONCLUSION The proposed classification allowed the identification of differences between the associated factors. Thus, the need to consider such classification in future studies is evident. RESUMO OBJETIVO Avaliar os fatores associados à perda dentária em adultos a partir da posição e do número de dentes perdidos nos arcos dentários. MÉTODOS Estudo transversal, populacional, com adultos participantes do levantamento epidemiológico de saúde bucal de São Paulo em 2015. O desfecho do estudo foi a perda dentária, avaliada pela classificação proposta, a saber: I) perdeu até 12 dentes posteriores; II) perdeu até 12 dentes (incluindo dentes anteriores); e III) perdeu acima de 12 dentes. Realizou-se uma análise em quatro blocos, apoiada em um modelo teórico conceitual adaptado para perdas dentárias. Para a regressão logística multinominal, usou-se “indivíduos que não tenham perdido dentes por cárie ou doença periodontal” como referência (p < 0,05). RESULTADOS De 6.051 adultos avaliados, 25,3% (n = 1.530) foram classificados na categoria I, 32,7% (n = 1.977) na II, 9,4% (n = 568) na III e 1,9% (n = 117) eram desdentados totais. A menor renda e escolaridade, a percepção de necessidade de tratamento e última consulta motivada por rotina, dor ou extração foram associados à perda dentária, independentemente da classificação. A avaliação negativa do serviço odontológico esteve associada aos indivíduos que perderam até 12 dentes, tanto anteriores quanto posteriores. O sexo feminino e a presença de bolsa periodontal foram associados a perdas dentárias de até 12 dentes, incluindo anteriores, e acima de 12 dentes. A presença de cárie foi associada aos adultos que perderam até 12 dentes, incluindo dentes anteriores. CONCLUSÃO A classificação proposta permitiu a identificação de diferenças entre os fatores associados. Assim, fica evidente a necessidade de considerá-la em estudos futuros.

OBJECTIVE: Estimate the prevalence and gravity of coronal dental caries for populations of adolescents, adults and elderly people.METHODS: For the crossing of data of the average DMF rates by Regional Health Directorate (RHD) with the digital cartographical base, municipals were grouped by RHD, and the connection between the two bases was formed by a common code or “primary key” in the TerraView® software program (version 4.2.1).RESULTS: The distribution of the DMF average for the teen population was the worst for RHD 8, while RHDs 4, 7 and 14 had lower averages. For the adult population, RHDs 4 and 12 presented the lowest DMF averages. On the other hand, RHDs 8, 13, and 16 had the worst results. For the elderly population, the RHD 4 presented the lowest average, and RHD 9 the highest DMF rate for this population.CONCLUSION: The differences in DMF averages among the RHDs and the populations studied showed that it is necessary to plan different locoregional oral health actions to face the severe clinical state exposed, since its spatial distribution is disparate, with concentrations of cases in certain regions for all age groups studied. OBJECTIVE: Estimate the prevalence and gravity of coronal dental caries for populations of adolescents, adults and elderly people.METHODS: For the crossing of data of the average DMF rates by Regional Health Directorate (RHD) with the digital cartographical base, municipals were grouped by RHD, and the connection between the two bases was formed by a common code or “primary key” in the TerraView® software program (version 4.2.1).RESULTS: The distribution of the DMF average for the teen population was the worst for RHD 8, while RHDs 4, 7 and 14 had lower averages. For the adult population, RHDs 4 and 12 presented the lowest DMF averages. On the other hand, RHDs 8, 13, and 16 had the worst results. For the elderly population, the RHD 4 presented the lowest average, and RHD 9 the highest DMF rate for this population.CONCLUSION: The differences in DMF averages among the RHDs and the populations studied showed that it is necessary to plan different locoregional oral health actions to face the severe clinical state exposed, since its spatial distribution is disparate, with concentrations of cases in certain regions for all age groups studied. *** Análise espacial da experiência de cárie em população de adolescentes, adultos e idosos do estado de São Paulo: dados do SB SP 2015 ***OBJETIVO: Estimar a prevalência, gravidade e distribuição da cárie dentária na população de adolescentes, adultos e idosos.METODOLOGIA: Para o cruzamento dos dados foi realizada a ligação entre as duas bases por um código comum ou “chave primária” no software TerraView® (versão 4.2.1).RESULTADOS: A distribuição da média CPOD para a população adolescente foi pior para a DRS 8, enquanto as DRS 4, 7 e 14 apresentaram as menores médias. Para a população adulta, as DRS 4 e 12 apresentaram as menores médias CPOD. Em contrapartida, as DRS 8, 13 e 16 mostraram os piores resultados. Em relação à população idosa, a DRS 4 apresentou menor média, e a DRS 9 a maior média CPOD para esta população.CONCLUSÃO: As diferentes médias dos CPOD entre as DRS e entre as populações estudadas demonstram a necessidade de planejamento de ações de saúde bucal locorregionais diferentes para o enfrentamento da heterogeneidade encontrada.Palavras-chave: cárie dentária; inquéritos epidemiológicos; inquéritos de saúde bucal; índice CPO; saúde bucal.

To evaluate the relationship between decayed, missing and filled teeth (DMF index) and body mass index (BMI).This was a cross-sectional, population-based study developed in 2015 at a primary health care (PHC) unit in the city of Sao Paulo, Brazil. Participants completed a form including sociodemographic and socioeconomic characteristics, nutritional, general health and oral health data. An anthropometric oral assessment was performed, and the association of DMFT and its components with not-categorised and categorised BMI was tested through simple and multiple logistic analysis, trend test and Spearman correlation.The sample consisted of 239 individuals aged 18 to 70 years. The prevalence of caries was 84.5%, the mean DMFT was 14.6 and the mean BMI was 27.46. There was positive association for DMFT with BMI and age, sex, formal education, hypertension, diabetes and use of dental floss. A positive association is also suggested between BMI and missing teeth.A correlation was observed between DMFT (missing teeth) and BMI. This can help to identify at-risk groups, plan progammes and treatment of overweight and obese individuals in primary health care.

We have sequenced a partial transcriptome of the Northern Wheatear (Oenanthe oenanthe), a species with one of the longest migrations on Earth. The transcriptome was constructed de novo using RNA-Seq sequence data from the pooled mRNA of six different tissues: brain, muscle, intestine, liver, adipose tissue and skin. The samples came from nine captive-bred wheatears collected at three different stages of the endogenous autumn migratory period: (1) lean birds prior the onset of migration, (2) during the fattening stage and (3) individuals at their migratory body mass plateau, when they have almost doubled their lean body mass. The sample structure used to build up the transcriptome of the Northern Wheatears concerning tissue composition and time guarantees the future survey of the regulatory genes involved in the development of the migratory phenotype. Through the pre-migratory period, birds accomplish outstanding physical and behavioural changes that involve all organ systems. Nevertheless, the molecular mechanisms through which birds synchronize and control hyperphagia, fattening, restlessness increase, immunity boosting and tuning the muscles for such endurance flight are still largely unknown. The use of RNA-Seq has emerged as a powerful tool to analyse complex traits on a broad scale, and we believe it can help to characterize the migratory phenotype of wheatears at an unprecedented level. The primary challenge to conduct quantitative transcriptomic studies in non-model species is the availability of a reference transcriptome, which we have constructed and described in this paper. The cDNA was sequenced by pyrosequencing using the Genome Sequencer Roche GS FLX System; with single paired-end reads of about 400 bp. We estimate the total number of genes at 15,640, of which 67% could be annotated using Turkey and Zebra Finch genomes, or protein sequence information from SwissProt and NCBI databases. With our study, we have made a first step towards understanding the migratory phenotype regarding gene expression of a species that has become a model to study birds long-distance migrations.

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.

This study evaluates the prevalence and risk factors of non-carious cervical lesions (NCCLs) in a Brazilian population of workers exposed and non-exposed to acid mists and chemical products. One hundred workers (46 exposed and 54 non-exposed) were evaluated in a Centro de Referência em Saúde do Trabalhador – CEREST (Worker’s Health Reference Center). The workers responded to questionnaires regarding their personal information and about alcohol consumption and tobacco use. A clinical examination was conducted to evaluate the presence of NCCLs, according to WHO parameters. Statistical analyses were performed by unconditional logistic regression and multiple linear regression, with the critical level of p < 0.05. NCCLs were significantly associated with age groups (18-34, 35-44, 45-68 years). The unconditional logistic regression showed that the presence of NCCLs was better explained by age group (OR = 4.04; CI 95% 1.77-9.22) and occupational exposure to acid mists and chemical products (OR = 3.84; CI 95% 1.10-13.49), whereas the linear multiple regression revealed that NCCLs were better explained by years of smoking (p = 0.01) and age group (p = 0.04). The prevalence of NCCLs in the study population was particularly high (76.84%), and the risk factors for NCCLs were age, exposure to acid mists and smoking habit. Controlling risk factors through preventive and educative measures, allied to the use of personal protective equipment to prevent the occupational exposure to acid mists, may contribute to minimizing the prevalence of NCCLs.

The objective of this research was to estimate the perception of dental fluorosis in children with 12 years old and associated variables. A cross-sectional study was conducted on 12 year old school children (393) from all of 10 public schools of Rio Grande da Serra town of Sao Paulo district. Only one dental surgeon, previously calibrated (Kappa = 0.84), performed all clinical examinations. A structured questionnaire was answered by the children themselves and also for their parents. The prevalence of dental fluorosis (Dean Index) found was 57%, restricted to the very mild and mild levels, but higher than expected for Brazilian standards. Significant associations between dental fluorosis stains and perception by children or guardians weren’t found. Dental fluorosis in the degree of severity found, had no adverse effect on the health of these children, but warns of the need for constant monitoring of these changes and rational use of fluoride.

Os serviços oferecidos pelo Sistema Único de Saúde (SUS) estão organizados em rede, de forma a oferecer a seus usuários uma atenção integral. Com esse propósito, a configuração desta rede de serviços deve privilegiar o acesso do usuário ao nível de atenção que possa oferecer resolução ao seu caso, disponibilizando um adequado sistema de referência e contrarreferência para o usuário que necessite ser encaminhado de um nível de atenção a outro. Sendo assim, este estudo tem por objetivo avaliar a percepção dos profissionais e usuários referente ao sistema de referência e contrarreferência, e como este sistema funciona no cotidiano das unidades envolvidas neste estudo. Trata-se de um estudo qualitativo, cujos dados foram coletados através da aplicação de um questionário que visava obter as representações sociais de profissionais e usuários sobre o tema proposto, bem como alguns aspectos operacionais sobre o funcionamento deste sistema nestas unidades. Posteriormente os resultados foram apresentados e analisados na forma do Discurso do Sujeito Coletivo e permitiram concluir que profissionais e usuários têm a mesma percepção a respeito dos problemas que afetam o bom funcionamento deste sistema, tais como falta de profissionais, demora no atendimento, falta de resolutividade da atenção básica, disponibilidade de serviços na atenção secundária em desacordo com as necessidades da população, dificuldades na comunicação entre os profissionais dos diferentes níveis de atenção, e uma deficiência no controle do fluxo dos usuários, fazendo com que o sucesso dos encaminhamentos dependa muitas vezes do empenho pessoal dos profissionais e do esforço pessoal dos próprios pacientes. The services offered by the Unified Health System (SUS) are organized in a network in order to offer its users an integral attention. For this purpose, the configuration of this services network should prioritize the users access to the health care level that can provide the solution to his case, and a suitable reference and counter reference system to the user that needs to be sent from a health care level to another. Thus, this study aims to evaluate the perception of professionals and users concerning the reference and counter reference system, and how this system works daily in the health units involved in this study. This is a qualitative study, where data were collected through the application of a questionnaire aimed to obtain the social representations of professionals and users about the proposed subject, as well as some operational aspects about the operation of this system at these health units. Subsequently the results were presented and analyzed in the form of Collective Subject Discourse and allow us to conclude that professionals and users have the same perception about the problems that affect the proper functioning of this system, such as lack of professionals, delay in treatment, lack of resoluteness of the primary health care, availability of services in secondary care at odds with people\'s needs, difficulties in communication between professionals of different health care levels, and a deficiency in controlling the flow of users, making the success of referrals dependent often on personal commitment of the professionals involved and of the patient\'s own efforts.

Objective: This study aimed to assess the oral impact on daily performance and its association with sociodemographic characteristics, tooth pain, need for prosthesis, and periodontal disease of adults in the state of Sao Paulo, Brazil. Methods: This was a cross-sectional epidemiological study with secondary data obtained from the Oral Health Conditions Project– 2015 conducted in 163 municipalities in the state of Sao Paulo with the participation of 17,560 individuals. This study evaluated adults in the age-range between 35–44 years (n = 5,855), selected by means of probabilistic cluster sampling in two stages. The outcome variable was the OIDP (Oral Impacts on Daily Performances), obtained by using this instrument to assess daily activities (eating, speaking, oral hygiene, relaxation, sports practice, smile, study/work, social contact, and sleep). The independent variables were collected and grouped into three blocks: Block 1 (sex, age group, and ethnic group); Block 2 (household income and education); and Block 3 (tooth pain, need for prosthesis, bleeding, calculus, and periodontal pockets). A hierarchical multiple logistic regression analysis was performed considering the complex cluster sampling plan. Each observation was assigned a specific weight, depending on the location, which resulted in weighted frequencies adjusted for the effect of outlining. Results: the female sex (p

Background Oral disorders may negatively affect the quality of life (QoL) of adolescents. To investigate how social vulnerability and oral-health status factors affect QoL in 15–19 years olds who participated in the “SB São Paulo 2015” state survey. Methods The relationship of several independent variables, namely Paulista Social Vulnerability Index (PSVI) score, gender, skin color, family income, age, untreated caries, tooth loss [determined by the Decayed, Missing, Filled-Teeth (DMF-T) index], toothache, periodontal condition [determined by the Community Periodontal Index (CPI)], and malocclusion (maxillary overjet, cross bite, or open bite) affect daily life, measured by the Oral Impacts on Daily Performance (OIDP) instrument. Logistic regression analyses were carried out based on a hierarchical model. Results The final sample consisted of 5402 adolescents. The prevalence of at least one negative impact of oral health on QoL was 37.3%. After adjustment, demographic factors that were found to influence this impact significantly (p

Resumen pt: Objetivo: Analisar a interferencia da saude bucal em funcoes biologicas e sociais, segundo a percepcao de adolescentes brasileiros de 15 a 19 anos. Metod...

The objective of the present study was to analyze individual, contextual and social support factors associated with periodontal condition among 2332 dentate elderly Brazilian participants from the Sao Paulo State Oral Health Survey 2015 (SBSP-15). Methods This study used the database compiled by the SBSP-15, conducted from January to December in 2015. The associations were made by relative risk (RR), with Multilevel Poisson Regressions, among individual, contextual and social support variables, and had periodontal diseases as outcomes. Results The mean age of elders was 70.13 years (SD 5.67). The risk factors for all outcomes of periodontal diseases were male gender and self-perceived color of non-white skin. Regarding social support, feeling unhappy was a risk factor for the presence of shallow periodontal pockets (3-5mm) RR 1.43(CI 95% 1.10-1.86). The coverage of the Family Health Strategy (FHS) was a protective factor for gingival bleeding RR = 0.7(CI 95% 0.44-0.99) and calculus RR = 0.75(CI 95% 0.60-0.95), and a risk factor for the number of lost sextants (sextants with only one tooth or without any teeth) RR = 1.12(CI 95% 1.00-1.28). Living in municipalities with more than 90% fluoridation coverage was a protective factor for the number of lost sextants RR = 0.89(CI 95% 0.78-0.99). Conclusions The study showed evidence that individual (gender and self-perceived skin color), contextual (coverage of the family health strategy and water fluoridation) and social support factors (feeling unhappy) are associated with the clinical outcomes of periodontal diseases in Brazilian elders. This reinforces the need for transdisciplinary actions in the FHS, stimulating work together and intersectoral collaboration between FHS and NASF (Family Health Support Center).

A educação a distância é uma modalidade de ensino que permite eliminar a separação geográfica entre educador e educando para atender a um número ilimitado de alunos que estejam em busca de formação, capacitação ou atualização profissional. Esta pesquisa teve por objetivo conhecer e explanar a vivência dos alunos da Especialização em Saúde da Família/Unasus/Unifesp, do município de Amparo, no processo de ensino-aprendizagem através do ensino a distância mediado por tecnologia, bem como avaliar o impacto da educação permanente na organização dos serviços. Através de um modelo de pesquisa qualitativa, buscou-se estabelecer a percepção dos alunos com relação a metodologia, técnica, estratégias de aprendizagem e mudanças ocorridas nos serviços em que estão inseridos os profissionais capacitados. As respostas foram classificadas segundo os eixos estabelecidos, buscando contextualizar o relato dos atores pesquisados. Após análise e avaliação desses discursos, foram estabelecidas relações e sínteses inerentes ao processo de ensino a distância e avaliação do impacto do curso de capacitação na organização e implementa- ção dos serviços. Observou-se que todas as narrativas referem a importância da educação permanente em Saúde como eixo propulsor de mudanças nos serviços e que a especialização foi exímia em qualidade e excelência. Mas, oportunamente, tais relatos destacaram que nem sempre as transformações desejadas aconteciam na mesma velocidade do proposto e assimilado pelo curso. A conclusão deste artigo destaca a importância do reconhecimento da educação permanente em saúde, devendo ser sempre incentivada e oferecida para grupos de profissionais, para possibilitar que seus cenários de prática sejam reorganizados e fortalecidos. Essa proposta de incentivo deve ter como intuito desenvolver práticas qualificadas socialmente e tecnicamente com aplicabilidade oportunizada por gestores e representantes municipais, estaduais e federais.

A Secretaria Municipal de Saúde de São Paulo desenvolveu o Índice de Necessidades em Saúde (INS) para identificar áreas prioritárias para a oferta de serviços. Em 2008 realizou um Levantamento das Condições de Saúde Bucal. Pretende-se, neste estudo ecológico, analisar o perfil de saúde bucal em relação ao INS. As variáveis, estratificadas para as idades de 5, 12 e 15 anos, foram: porcentagem de indivíduos com dificuldade no acesso ao serviço odontológico; média do ceod e CPOD; prevalência da necessidade de extração e de livres de cárie. As informações foram analisadas para as 25 Supervisões Técnicas de Saúde (STS). Empregou-se o teste estatístico de covariância, o coeficiente de correlação de Pearson e o modelo de regressão linear. Observou-se uma correlação positiva entre maiores INS e a dificuldade de acesso aos serviços. Nas STS com maiores INS houve maior experiência de cárie, maior necessidade de exodontias e menor prevalência de livres de cárie. Reforça-se a necessidade de priorizar as áreas de privação social para melhorar a condição de saúde da população.The Health Department of São Paulo, Brazil, has developed a Health Necessities Index (HNI) to identify priority areas for providing health assistance. In 2008, a survey of the status of oral health was conducted. The objective of this ecological study was to analyze the status of oral health in relation to the HNI. The variables, stratified by the age of 5, 12 and 15 years old were: percentage of individuals with difficulty of access to dental care services; DMFT and DMFS; prevalence of the need for tooth extraction and treatment of dental caries. Data were analyzed for the 25 Health Technical Supervision Units (HTS). The Statistical Covariance Test was used as well as the Pearson correlation coefficient and linear regression model. A positive correlation was observed between high scores of the HNI and difficulty of access to services. In the HTS with high scores of HNI a higher incidence of dental caries was observed, a greater need for tooth extractions and low caries-free incidence. In order to improve health conditions of the population it is mandatory to prioritize actions in areas of social deprivation.

A Secretaria Municipal de Saúde de São Paulo desenvolveu o Índice de Necessidades em Saúde (INS) para identificar áreas prioritárias para a oferta de serviços. Em 2008 realizou um Levantamento das Condições de Saúde Bucal. Pretende-se, neste estudo ecológico, analisar o perfil de saúde bucal em relação ao INS. As variáveis, estratificadas para as idades de 5, 12 e 15 anos, foram: porcentagem de indivíduos com dificuldade no acesso ao serviço odontológico; média do ceod e CPOD; prevalência da necessidade de extração e de livres de cárie. As informações foram analisadas para as 25 Supervisões Técnicas de Saúde (STS). Empregou-se o teste estatístico de covariância, o coeficiente de correlação de Pearson e o modelo de regressão linear. Observou-se uma correlação positiva entre maiores INS e a dificuldade de acesso aos serviços. Nas STS com maiores INS houve maior experiência de cárie, maior necessidade de exodontias e menor prevalência de livres de cárie. Reforça-se a necessidade de priorizar as áreas de privação social para melhorar a condição de saúde da população. The Health Department of São Paulo, Brazil, has developed a Health Necessities Index (HNI) to identify priority areas for providing health assistance. In 2008, a survey of the status of oral health was conducted. The objective of this ecological study was to analyze the status of oral health in relation to the HNI. The variables, stratified by the age of 5, 12 and 15 years old were: percentage of individuals with difficulty of access to dental care services; DMFT and DMFS; prevalence of the need for tooth extraction and treatment of dental caries. Data were analyzed for the 25 Health Technical Supervision Units (HTS). The Statistical Covariance Test was used as well as the Pearson correlation coefficient and linear regression model. A positive correlation was observed between high scores of the HNI and difficulty of access to services. In the HTS with high scores of HNI a higher incidence of dental caries was observed, a greater need for tooth extractions and low caries-free incidence. In order to improve health conditions of the population it is mandatory to prioritize actions in areas of social deprivation.

This study presents the strategies for prevention and early detection of oral cancer by means of screening in the elderly population of São Paulo, the richest and the most populous state of Brazil. This research was a retrospective longitudinal study based on the analysis of secondary data. The variables - number of participating cities, coverage of screening, and number of suspicious and confirmed cases of oral cancer - were divided into two periods: 2001-2004 and 2005-2008. Data were analyzed statistically by the chi-square test at 5% significance level. The implementation of a nationwide public oral health policy in 2004 and the reorganization of the secondary and tertiary health care were evaluated as mediator factors able to interfere in the achieved outcomes. From 2001 to 2008, 2,229,273 oral examinations were performed. There was an addition of 205 participating cities by the end of the studied period (p

OBJETIVO: Este estudo descreveu a prevalência de condições periodontais e sua associação com variáveis demográficas, socioeconômicas e comportamentais em adultos de 35 a 44 anos residentes no município de Guarulhos, São Paulo, 2006. MÉTODOS: Foi realizado estudo transversal de base populacional com delineamento amostral por conglomerados. Os inquéritos e os exames foram realizados nos domicílios sorteados. Para avaliação da condição periodontal foi utilizado o índice Community Periodontal Index (CPI). Os dados foram apurados pelo programas EPIINFO 6 e STATA 10. Para o modelo de associação empregou-se a razão de prevalências (RP), calculada por meio de análise de regressão de Poisson, com correção para delineamento de amostras complexas e ponderação pelo peso populacional. RESULTADOS: Foram examinadas 263 pessoas em 237 domicílios. No estudo multivariado, com modelo ajustado para amostras complexas e ponderação populacional, a prevalência de sangramento gengival e cálculo dentário esteve associada significativamente ao fato de ser homem (RP=1,12, p=0,04), fumante (RP=1,11, p=0,01), ter menos de oito anos de estudo (RP=1,14, p=0,01) e não visitar o cirurgião-dentista (CD) há mais de dois anos (RP=1,19, p=0,00). Para a presença de bolsa periodontal, houve associação com adultos que relataram o hábito de fumar (RP=1,71, p=0,02) e apresentavam mais de dois anos sem frequentar o CD (RP=1,97, p=0,03). CONCLUSÃO: Houve maior prevalência (62,7%) de indivíduos com sangramento gengival e cálculo dentário em relação à presença de bolsas periodontais rasas ou profundas (26,6%); as primeiras, reversíveis, têm possibilidades de resolução por meio de procedimentos de atenção básica em saúde bucal. OBJECTIVE: This study described the prevalence of periodontal conditions and assessed its association with social, economical and behavioral variables in adults aged 35 to 44 years old, residents in the city of Guarulhos, State of Sao Paulo, 2006. METHODS: This study was a population based survey with cluster sampling. Data collecting and exams were done at houses drew at random. The Community Periodontal Index was used to assess the periodontal condition. Data analysis used EPIINFO 6 and STATA 10 softwares. The assessment of association used the prevalence ratio (PR), as calculated by Poisson regression models with complex sampling and weighted sample adjustments. RESULTS: The total number of people was 263 in 237 domiciles. In the multivariate model, the prevalence of gingival bleeding and dental calculus was significantly associated to being male (PR=1.12, p=0.04), smoking (PR=1.11, p=0.01), school level of less than eight years of study (PR=1.14, p=0.01), and who have not received dental care for more than two years (PR=1.19, p

OBJETIVO: Este estudo descreveu a prevalência de condições periodontais e sua associação com variáveis demográficas, socioeconômicas e comportamentais em adultos de 35 a 44 anos residentes no município de Guarulhos, São Paulo, 2006. MÉTODOS: Foi realizado estudo transversal de base populacional com delineamento amostral por conglomerados. Os inquéritos e os exames foram realizados nos domicílios sorteados. Para avaliação da condição periodontal foi utilizado o índice Community Periodontal Index (CPI). Os dados foram apurados pelo programas EPIINFO 6 e STATA 10. Para o modelo de associação empregou-se a razão de prevalências (RP), calculada por meio de análise de regressão de Poisson, com correção para delineamento de amostras complexas e ponderação pelo peso populacional. RESULTADOS: Foram examinadas 263 pessoas em 237 domicílios. No estudo multivariado, com modelo ajustado para amostras complexas e ponderação populacional, a prevalência de sangramento gengival e cálculo dentário esteve associada significativamente ao fato de ser homem (RP=1,12, p=0,04), fumante (RP=1,11, p=0,01), ter menos de oito anos de estudo (RP=1,14, p=0,01) e não visitar o cirurgião-dentista (CD) há mais de dois anos (RP=1,19, p=0,00). Para a presença de bolsa periodontal, houve associação com adultos que relataram o hábito de fumar (RP=1,71, p=0,02) e apresentavam mais de dois anos sem frequentar o CD (RP=1,97, p=0,03). CONCLUSÃO: Houve maior prevalência (62,7%) de indivíduos com sangramento gengival e cálculo dentário em relação à presença de bolsas periodontais rasas ou profundas (26,6%); as primeiras, reversíveis, têm possibilidades de resolução por meio de procedimentos de atenção básica em saúde bucal.OBJECTIVE: This study described the prevalence of periodontal conditions and assessed its association with social, economical and behavioral variables in adults aged 35 to 44 years old, residents in the city of Guarulhos, State of Sao Paulo, 2006. METHODS: This study was a population based survey with cluster sampling. Data collecting and exams were done at houses drew at random. The Community Periodontal Index was used to assess the periodontal condition. Data analysis used EPIINFO 6 and STATA 10 softwares. The assessment of association used the prevalence ratio (PR), as calculated by Poisson regression models with complex sampling and weighted sample adjustments. RESULTS: The total number of people was 263 in 237 domiciles. In the multivariate model, the prevalence of gingival bleeding and dental calculus was significantly associated to being male (PR=1.12, p=0.04), smoking (PR=1.11, p=0.01), school level of less than eight years of study (PR=1.14, p=0.01), and who have not received dental care for more than two years (PR=1.19, p

Trata-se de um relato de experiência sobre a introdução de conteúdos e estratégias pedagógicas na disciplina de Saúde Coletiva em Odontologia da Faculdade de Odontologia da Universidade de São Paulo (FOUSP) que, seguindo as orientações das Diretrizes Curriculares Nacionais para cursos de Odontologia, utiliza o Sistema Único de Saúde (SUS) como cenário pedagógico, permitindo ao aluno vivenciar e dialogar com a realidade in loco, ampliando o olhar e a escuta. Por meio de módulos de conteúdo aplicados com uma pedagogia baseada em problemas, a construção da teoria é complementada com visitas técnicas ao SUS do município de Embu das Artes, além da elaboração, ao longo do ano e em grupo, de uma política municipal de saúde bucal de outro município do estado de São Paulo. A experiência propõe fornecer ao aluno instrumentos de análise críticoreflexiva, inserindo sua prática num contexto social que visa a atender as necessidades em saúde da população.

OBJETIVO: Analisar se variáveis clínicas, sociodemográficas e de acesso aos serviços odontológicos influenciam o impacto da saúde bucal nas atividades diárias de adolescentes, adultos e idosos. MÉTODOS: Estudo transversal com dados secundários da Pesquisa Estadual de Saúde Bucal (SB São Paulo 2015) realizada em 163 municípios de São Paulo. Participaram do inquérito 17.560 indivíduos de três grupos etários: adolescentes de 15–19 anos (n = 5.558), adultos de 35–44 anos (n = 6.051) e idosos de 65 anos ou mais (n = 5.951). A seleção foi feita por amostra probabilística por conglomerados em dois estágios. A variável desfecho foi o impacto da saúde bucal sobre as atividades diárias, avaliado pelo questionário Oral Impacts on Daily Performances, contendo questões sobre comer, falar, higiene bucal, relaxamento, prática esportiva, sorriso, estudo ou trabalho, contato social e sono. O Oral Impacts on Daily Performances foi dicotomizado em com e sem impacto. As variáveis independentes foram as sociodemográficas, clínicas e de acesso, divididas em três blocos. Realizou-se análise de regressão logística múltipla hierarquizada considerando o plano amostral complexo de conglomerados. Cada observação recebeu um peso específico, dependendo da localização que resultou em frequências ponderadas e ajustadas para o efeito do delineamento. RESULTADOS: A presença de impacto da saúde bucal foi constatada em 27,9% dos indivíduos. No bloco 1, o sexo feminino e o grupo étnico preto/pardo tiveram maior chance de impacto da saúde bucal na qualidade de vida, bem como os adultos e idosos em relação aos adolescentes. No bloco 2, a renda familiar até R$1.500 teve associação com a presença de impacto. No bloco 3, os indivíduos que relataram dor de dente, frequentaram o serviço público e procuraram tratamento odontológico tiveram maior chance de impacto. CONCLUSÕES: As variáveis sociodemográficas, clínica e de acesso ao serviço de saúde influenciam o impacto da saúde bucal nas atividades diárias de adolescentes, adultos e idosos.