Relação das condições socioeconômicas com as condições de saúde bucal em capitais brasileiras

Despite the improvement of Brazilian s living conditions in recent decades, this improvement occurred in a polarized way between groups of better social position. Then, there is still a health inequity´s panorama in Brazil which encompasses the oral health state. This panorama instigated the attainment of this ecological study that aimed to evaluate the relationship of socioeconomic conditions, and public health policies with oral health status in Brazilian capitals. Thus, we performed factor analysis and linear regression using oral health indicators collected from SB Brasil 2010, of socioeconomic conditions from Brazilian Census 2010 and related to water´s supply fluoridation from SISAGUA. Factor analysis with indicators of living conditions revealed two common factors, economic deprivation and socio-sanitary condition. Economic deprivation showed statistically significant positive correlation with DMFT 12 years (p= 0,03) and mean missing teeth (p = 0,002) and negative correlation with caries-free population (p=0,012). Socio-sanitary negatively correlated with DMFT (p <0,0001) and a positive correlation with caries-free population (p = 0.002). Fluoridated water had a significant association with DMFT (p <0,0001), mean missing teeth (p <0,0001) and caries free population (p <0.0001). Multiple linear regression analysis for the DMFT of capital was estimated by socio-sanitary condition and fluoridation, adjusted by economic deprivation, whereas the model for the mean missing teeth was estimated only by fluoridation and economic deprivation, and finally the model the rate for the population free of caries in Brazilian capitals was estimated by economic and socio-sanitary status adjusted fluoridated water supply. Therefore, factors related to living conditions and public policies are intrinsically linked to tooth decay issues. Thus, actions, beyond dental care assistance, must be development to impact positively in social and economic conditions, especially, between the most vulnerable populations

Impacto da cárie precoce severa na infância na qualidade de vida relacionada à saúde bucal de pré-escolares sob privação social

Early childhood caries, especially in its severe form, which is characterized by an acute and aggressive nature, can have negative impacts on thequality of life of a child, due to effects such as difficulty in chewing, decreased appetite, weight loss, insomnia, changes in behavior and a decreased performance in school, among others. Moreover, the quality of life of the child`s family can also be affected, as the pain and discomfort caused by this type of caries result in loss of working days of parents, spending on dental treatments, changes in sleep patterns and stress. The aim of this study was to evaluate the impact of severe early childhood caries in the Oral Health-Related Quality of Life (OHRQoL) of public daycares`s preschool children through the Escala de Impacto da Saúde Bucal na Primeira Infância, a Brazilian version of the Early Childhood Oral Health Impact Scale (ECOHIS). A single calibrated examiner (kappa=1.0) evaluated, through the dmfs index, the oral health of 116 children aged between 3 and 5, which were included in one of three study groups: "caries-free", "not-severe early childhood caries" and "severe early childhood caries". The parents responded to ECOHIS, to assess their perception regarding the OHRQoL of their children, and a questionnaire on socioeconomic conditions. The OHRQoL was measured through the total scores and domains of ECOHIS. Descriptive analysis, Mann-Whitney test, Kruskal-Wallis test, chi-square test and Poisson multiple regression with robust variance were used. Among the children observed, 38.8% were caries-free, 27.6% showed not-severe early childhood caries and 33.6% showed severe early childhood caries. Regarding the total score of ECOHIS, severe early childhood caries had a greater negative impact on OHRQoL, compared to caries-free and not-severe early childhood caries groups (p <0.001). Regarding the child subscale, there was significant difference between the "severe early childhood caries" group and the other groups in all domains, except for theone of self-image / social interaction. In the family subscale domains, there was statistical significance between the severe early childhood caries and the caries-free groups in all domains (p <0.001), whereas between the "severe early childhood caries and not-severe early childhood caries groups there was a statistically significant difference only in the domain of parental anguish (p <0.001). Multivariate analysis showed that early childhood caries and the parent`s age were significantly associated to OHRQoL (p <0.05), independently of the other variables in the model. The presence of severe early childhood caries resulted in greater negative impact on OHRQoL (AdjPR= 6.016; 95%CI = 3.12 11.56; p<0.001), while older parents reported better OHRQoL (AdjPR = 0.603; 95%CI = 0.428 - 0.850; p = 0.004). The presence of severe early childhood caries had a negative impact on OHRQoL of preschool children and their families.

Fatores socioeconômicos contextuais associados à condição bucal de adolescentes no Brasil

Many surveys are conducted comparing oral health conditions with individual variables, such as socioeconomic and demographic factors. However, in the same way that individuals differ among themselves, the groups also have their own characteristics and the effects of this differentiation must be researched. Brazil, despite being one of the major economic powers of the world and shows an improvement in the average value of its health indicators, is also one of the most unequal and remains among the countries with the greatest health inequities. The purpose of this study was to investigate the importance of social determinants on the contextual level oral health among Brazilian adolescents, population not much researched by the literature. The research was made using an ecological approach in order to identify possible inequalities between cities and capitals. Using data from SBBrasil 2010 it was evaluated less common outcomes (loss of first molar, dental care index and T-Health) which provide information on the degree of morbidity of caries and health level of dental tissues, in addition to analyze the related services. The association of these oral health indicators with socioeconomic factors such as income, employment, education and inequality, collected from Census 2010, was analyzed by simple and multiple linear regressions. The study included the 27 state capitals and four clusters representing the municipalities of the country. It was possible to see better access to services in locations with better income distribution. However, the strong association of contextual factors related to poverty, low levels of education and poor housing and jobs with poorer levels of oral health in adolescents seems to overshadow the effects of income inequalities on dental caries in the country. In some locations, particularly within the North and Northeast, whichever one keeps dentistry mutilating, whose effects are already noticeable in its adolescent population. Access to restorative services in Brazil remains limited and unequal. The results of this study highlight the inequities in oral health in the country and show the need of the inclusion of new perspectives on the traditional approach of Preventive Dentistry and education models in Dentistry. Tackling health inequalities in oral health in the country requires the cooperation of various actors involved in the process and the inclusion of oral health in the context of overall health. The social determinants approach, as well as evaluating the distribution of oral diseases in the country and its inclusion in the context of overall health, should guide the implementation of programs and oral health practices in order to contribute to the reduction of inequalities

Influência das condições de saúde bucal no desempenho das atividades diárias de adolescentes escolares

Instruments are used in odontology to measure the Quality of Life Related to Oral Health (OHRQoL) to scale how the oral condition interferes with functional areas, of the people s psychological and social life. This cross-sectional study, held in Natal/RN, with 215 students from the Federal Institute of Education, Science and Technology of Rio Grande do Norte (IFRN) has investigated the association between the performance of daily activities and oral health status of school adolescents from 15 to 19 years of age, through the normative index DMFT (permanent teeth decayed, missing and filled), CPI (Community Periodontal Index) and DAI (dental Aesthetic Index) and subjective questionnaire assessment of quality of life related oral health OIDP index (oral impacts on daily performance). It was also carried out the socioeconomic characteristics of students through IFRN own data. Concerning the analysis of data was performed a descriptive analysis of the variables by their absolute and relative frequencies and measures of central tendency. The chi-square test was used to assess the association between the dependent variable and the independent categorical variables and the Student t test for quantitative. It was also conducted a further multiple analysis out using Poisson regression with robust variance between the outcome "presence of impact" and the independent variables that showed p <0.20. It was used for all the statistical tests a significance level of 5%. Among the adolescents surveyed, 51.16% reported that at least one activity assessed by OIDP had hampered its implementation due to some dental problem. The difficulties were more pronounced in the activities of eating (31.6%), oral hygiene (25.6%) and smile (25.1%).The tooth position, followed by toothache, were the causes of the impacts reported by most teenagers. There was a significant association between the presence and impact of the presence of one or more decayed teeth (p = 0.012), the presence of gum bleeding (p = 0.012) and for orthodontic treatment (p = 0.003), independently of other variables. There was no significant association between oral health status and socioeconomic and demographic characteristics of the adolescents. The survey results showed that there is an association between oral health status of the population studied and reports of difficulties in carrying out daily activities evaluated. The worse the oral health status, the greater the impact of this condition on the adolescents quality of life

Produção e validação de um indicador de saúde bucal para idosos a partir de dados secundários do SB Brasil 2010

Dentre os vários aspectos da saúde do idoso, a saúde bucal merece atenção especial pelo fato de que, historicamente, nos serviços odontológicos, não se considera esse grupo populacional como prioridade de atenção. Por isso, se faz necessária a produção de um indicador multidimensional capaz de mensurar todas as alterações bucais encontradas em um idoso, facilitando a categorização da saúde bucal como um todo. Tal indicador representará um importante instrumento capaz de elencar prioridades de atenção voltadas à população idosa. Portanto, o estudo em questão propõe a produção e validação de um indicador de saúde bucal a partir dos dados secundários coletados pelo projeto SB Brasil 2010 referente ao grupo etário de 65 a 74 anos. A amostra foi representada pelos 7619 indivíduos do grupo etário de 65 a 74 anos que participaram da pesquisa nas 5 (cinco) regiões do Brasil. Tais indivíduos foram submetidos à avaliação epidemiológica das condições de saúde bucal, a partir dos índices CPO-d, CPI e PIP. Além disso, verificou-se o uso e necessidade de prótese, bem como características sociais, econômicas e demográficas. Uma análise fatorial identificou um número relativamente pequeno de fatores comuns, através da análise de componentes principais. Após a nomenclatura dos fatores, foi realizada a soma dos escores fatoriais por indivíduo. Por último, a dicotomização dessa soma nos forneceu o indicador de saúde bucal proposto. Para esse estudo foram incluídas na análise fatorial 12 variáveis de saúde bucal oriundas do banco de dados do SB Brasil 2010 e, também 3 variáveis socioeconômicas e demográficas. Com base no critério de Kaiser, observa-se que foram retidos cinco fatores que explicaram 70,28% da variância total das variáveis incluídas no modelo. O fator 1 (um) explica sozinho 32,02% dessa variância, o fator 2 (dois) 14,78%, enquanto que os fatores 3 (três), 4 (quatro) e 5 (cinco) explicam 8,90%, 7,89% e 6,68%, respectivamente. Por meio das cargas fatoriais, o fator um foi denominado dente hígido e pouco uso de prótese , o dois doença periodontal presente , o três necessidade de reabilitação , já o quarto e quinto fator foram denominados de cárie e condição social favorável , respectivamente. Para garantir a representatividade do indicador proposto, realizou-se uma segunda análise fatorial em uma subamostra da população de idosos investigados. Por outro lado, a aplicabilidade do indicador produzido foi testada por meio da associação do mesmo com outras variáveis do estudo. Por fim, Cabe ressaltar que, o indicador aqui produzido foi capaz de agregar diver sas informações a respeito da saúde bucal e das condições sociais desses indivíduos, traduzindo assim, diversos dados em uma informação simples, que facilita o olhar dos gestores de saúde sobre as reais necessidades de intervenções em relação à saúde bucal de determinada população

As diretrizes da política pública de saúde bucal e suas inflexões nos serviços da Clínica Odontológica da UFRN

The crisis that the Brazilian State have been crossing throughout the last decades has revealed intense oscillations in the the way of life of the population reality. In the health area, specifically of buccal health, new alternatives of attending to demands for odontological services have been increasing from the 1990 decade. The research had as objective to analyze the demand of the services of the clinic-school of odontology of the UFRN to identify the socio-economic profile of the users and the inflections of the standards of the National Politics of Buccal Health. The methodology is based on a dialectic perspective and a quali-quantitative boarding. It was used as instrument of data collection forms with open and closed questions, applied to two distinguished groups of citizens: 53 users of the services and 12 pupils of 9th and 10th term of the Odontology Course. The results reaffirm that, with the aggravation of the crisis of SUS (Sistema Único de Saúde- Single Health System) grow the difficulties of accessing the odontological services of the users majority. The subjects of the research make use of a regular socio-economic condition, with high school, own house, formal bond to labor and monthly medium income between 1 and 2 minimum wages. The conclusive analyses point to the selective and exculpatory character of the buccal health right, mainly, those users who find themselves in situation of extreme poverty and social vulnerability. Immediate and of lesser cost odontological assistance is what it s aimed, but the standards praised in the Public Politics of Buccal Health walk in another direction, requiring a bigger strongness of the formation bases and implementation of the programmatical actions since the academic field until the effectiveness of Politics of Buccal Health as a right while as a right to attention and care

Utilizando Pesos estáticos e dinâmicos em sistemas multi-classificadores com diferentes níveis de diversidade

Although some individual techniques of supervised Machine Learning (ML), also known as classifiers, or algorithms of classification, to supply solutions that, most of the time, are considered efficient, have experimental results gotten with the use of large sets of pattern and/or that they have a expressive amount of irrelevant data or incomplete characteristic, that show a decrease in the efficiency of the precision of these techniques. In other words, such techniques can t do an recognition of patterns of an efficient form in complex problems. With the intention to get better performance and efficiency of these ML techniques, were thought about the idea to using some types of LM algorithms work jointly, thus origin to the term Multi-Classifier System (MCS). The MCS s presents, as component, different of LM algorithms, called of base classifiers, and realized a combination of results gotten for these algorithms to reach the final result. So that the MCS has a better performance that the base classifiers, the results gotten for each base classifier must present an certain diversity, in other words, a difference between the results gotten for each classifier that compose the system. It can be said that it does not make signification to have MCS s whose base classifiers have identical answers to the sames patterns. Although the MCS s present better results that the individually systems, has always the search to improve the results gotten for this type of system. Aim at this improvement and a better consistency in the results, as well as a larger diversity of the classifiers of a MCS, comes being recently searched methodologies that present as characteristic the use of weights, or confidence values. These weights can describe the importance that certain classifier supplied when associating with each pattern to a determined class. These weights still are used, in associate with the exits of the classifiers, during the process of recognition (use) of the MCS s. Exist different ways of calculating these weights and can be divided in two categories: the static weights and the dynamic weights. The first category of weights is characterizes for not having the modification of its values during the classification process, different it occurs with the second category, where the values suffers modifications during the classification process. In this work an analysis will be made to verify if the use of the weights, statics as much as dynamics, they can increase the perfomance of the MCS s in comparison with the individually systems. Moreover, will be made an analysis in the diversity gotten for the MCS s, for this mode verify if it has some relation between the use of the weights in the MCS s with different levels of diversity

Dilema da diversidade-acurácia: um estudo empírico no contexto de multiclassificadores

Multi-classifier systems, also known as ensembles, have been widely used to solve several problems, because they, often, present better performance than the individual classifiers that form these systems. But, in order to do so, it s necessary that the base classifiers to be as accurate as diverse among themselves this is also known as diversity/accuracy dilemma. Given its importance, some works have investigate the ensembles behavior in context of this dilemma. However, the majority of them address homogenous ensemble, i.e., ensembles composed only of the same type of classifiers. Thus, motivated by this limitation, this thesis, using genetic algorithms, performs a detailed study on the dilemma diversity/accuracy for heterogeneous ensembles

Análise das medidas de boa e má diversidade na construção de comitês de classificadores através de metaheurísticas de otimização multiobjetivo

Committees of classifiers may be used to improve the accuracy of classification systems, in other words, different classifiers used to solve the same problem can be combined for creating a system of greater accuracy, called committees of classifiers. To that this to succeed is necessary that the classifiers make mistakes on different objects of the problem so that the errors of a classifier are ignored by the others correct classifiers when applying the method of combination of the committee. The characteristic of classifiers of err on different objects is called diversity. However, most measures of diversity could not describe this importance. Recently, were proposed two measures of the diversity (good and bad diversity) with the aim of helping to generate more accurate committees. This paper performs an experimental analysis of these measures applied directly on the building of the committees of classifiers. The method of construction adopted is modeled as a search problem by the set of characteristics of the databases of the problem and the best set of committee members in order to find the committee of classifiers to produce the most accurate classification. This problem is solved by metaheuristic optimization techniques, in their mono and multi-objective versions. Analyzes are performed to verify if use or add the measures of good diversity and bad diversity in the optimization objectives creates more accurate committees. Thus, the contribution of this study is to determine whether the measures of good diversity and bad diversity can be used in mono-objective and multi-objective optimization techniques as optimization objectives for building committees of classifiers more accurate than those built by the same process, but using only the accuracy classification as objective of optimization

Ambientes residenciais controlados por dispositivos móveis: estudo, concepção e desenvolvimento de um aplicativo considerando a diversidade

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Diversidade de Seirini (Collembola, Arthropleona, Entomobryidae), em áreas úmidas da caatinga

The family Entomobryidae is one of the most diverse families of Collembola in Northeast Brazil. Data on its diversity may be considered undervalued due to low collection efforts in the region. In this study, five areas in the Northeast region were sampled, to evaluate the species richness of this family. The study was done in the Serra da Jibóia, Santa Terezinha municipality, Bahia; Serra das Confusões, Caracol municipality, Piauí; Chapada do Araripe, Crato municipality, Ceará; Mata do Pau-Ferro, Areia municipality, Paraíba and Parque Nacional de Ubajara, Ubajara municipality, Ceará, all considered humid areas of Caatinga. Collections were made using pitfall traps and entomological aspirators. All the collected material was screened, mounted on slides, identified and, finally, the descriptions of some of the new species encountered were made. A total of 48 Entomobryidae species belonging to nine genera were recorded and 27 of these were new to science, representing a percentage of 56.25% of the total. A new record for Brazil was identified and several new records were made to the States. Seira was the genus with wider distribution and it was the only one found in all areas and the most representative with the highest number of recorded species (26). This result was expected, because individuals of the genus Seira have a good adaptability to semi-arid environments, a fact that has already been proven in previous research. Seven new species of Seira were described. A dichotomous key to genera and species of Seirini from Brazil was drafted. This work demonstrates the great potential of Entomobryidae and Seirini in the Northeast, despite having been held in very restricted areas, obtained important results for the knowledge of fauna of the group

Diversidade de paronellidae (collembola, arthropleona, entomobryoidea) no nordeste brasileiro, com ênfase em áreas úmidas da caatinga

Paronellidae is among the most diverse and distinctive components of epiedaphic Collembola in tropical countries. However, only 15 species of the family were recorded in Brazil, and only two of them were record in northeast region of the country. This condiction is clearly related to low sampling efforts and lack of specialists working with the group. Due to this reality, this work aimed to study the Paronellidae fauna, under a taxonomic point of view, in six distinct environments in Northeastern Brazil (from Alagoas, Bahia, Ceará, Piauí and Paraíba states), five areas of Caatinga and one from Atlantic Rain Forest biome. Collections were made during the rainy season on each area. The specimens were analyzed under stereomicroscope and mounted in glass slides for microscopy. The specimens identified as Paronellidae had their occurrence recorded and five new species were described. An identification key to the brazilian genera of the family was also prepared. Twelve species of Paronellidae were recorded for the first time to Brazil: Campylothorax mitrai; Lepidonella. sp. nov. 1; Lepidonella sp. nov. 2, Lepidonella sp. nov. 3, Lepidonella sp. nov 4, Lepidonella sp. nov. 5; Dicranocentruga sp. Nov. 1; Dicranocentruga sp. Nov. 2; Dicranocentruga sp. Nov. 3; Paronella sp. nov.1; Serroderus sp. nov.1 and Trogolaphysa. sp. 1, where C. mitrai, Lepidonella. sp. nov 1, Dicranocentruga sp. nov 1, Dicranocentruga sp. nov 2 and Dicranocentruga sp. nov 3 were described. Serroderus and Dicranocentruga genera were recorded for the first time to Brazil. The description of Lepidonella sp. nov 1 also represents the first description of a species of the genus for the country. The data presented show a high potential species richness to Paronellidae, not only in the northeast region, but as in Brazil. In fact, with the records presented in this work, the number of recorded species of Paronellidae in the country increased by 80%. The study of this particular fauna may direct environmental conservation policies, especially in areas of Caatinga