Hepatitis C virus and dental health workers: an update

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Self-perception and oral health in pregnant adolescents

To evaluate the oral health indicators by determining the experience of dental caries and periodontal disease and identification of self-perceived oral health status of pregnant adolescents and to assess the association between the studied variables. A transversal study, survey type and survey of the oral health status of 127 adolescents, 10-19 years of age, pregnant, accompanied by the Unified Health System of Araçatuba-SP was performed. The self-perceived oral health and socio-demographic data were recorded using an adapted questionnaire. The oral health statuses were analyzed using the DMFT and CPI indices in accordance with the criteria established by the WHO for epidemiological survey. Descriptive statistical analyzes and the Fisher's exact test with a significance level of 5% was performed, as well as a logistic regression analysis to verify the association between the variables. Of the total, 41.0% reported having satisfactory oral health, while 63.0% believed they had problems with their teeth and gums. The DMFT index was 12.51 (SD = 4.21). The percentage of caries-free was 6.3%, and 91.3% had periodontal problems. A statistically significant association was found between the variables: self-perceived oral health and periodontal disease p = 0.0166 and self-reported gum disease and periodontal disease p = 0.0039. Most patients considered their oral health as poor and reported having dental and gum problems, which can also be observed in the clinical examination since the caries experience of the pregnant women examined was considered high and the symptoms of periodontal disease were observed in most of the volunteers.

Work conditions and occupational health of dentists in Brazilian public health system

Conselho Nacional de Desenvolvimento Ciêntífico e Tecnológico (CNPq)

Compensatory Health Beliefs Predict Maladaptive Coping, Impulsivity, and Erroneous Health Perceptions

Compensatory Health Beliefs (CHB) are a common strategy used to reduce the cognitive discomfort that arises from participating in recognizably unhealthy behaviors. The current research examines relationships between CHB and other cognitive variables. Data was collected in two phases, using survey methodology. Study 1 explored relationships between the use of CHB, impulsiveness, and coping styles. Study 2 expanded the inquiry by exploring relationships to health perception and knowledge. Results revealed that participants who scored high on overall CHB were more likely to: engage in maladaptive coping strategies (r = .47, p < .01) [including avoidant coping styles (r = .38, p < .01) and unhealthy coping styles (r = .47, p < .01)], score higher on measures of impulsivity (r = .43, p < .01), be well-informed about their general health (r =-.21, p < .05), eat fast food more often ( r = p < .05), and consider it safe to smoke more frequently (r = .18, p < .05). Participants with lower CHB scores considered themselves more well-informed about their general health (r = -.21, p < .05), including understanding the minimum recommended amounts of physical activity needed to maintain health (r = -.35, p < .01 ), and knowing the health risks of stress ( r = -.19, p < .05). In addition, maladaptive coping was positively correlated with lack of general health knowledge (r = -.22 p < .01), less understanding of the risks of stress and alcohol (r = .20, p < .05), less knowledge of the recommended daily amounts of physical activity needed for health (r = -.26, p < .01), less frequent exercise (r = -.26, p < .01 ), and generally more unhealthy daily habits (r = -.26, p < .01). These findings contribute to a new area of investigation and may be useful to those who want to motivate behavior change.

Studies on the Helminth Fauna of Alaska. XXV. The Ecology and Public Health Significance of Echinococcus sibiricensis Rausch & Schiller, 1954, on St. Lawrence Island

The occurrence of a species of Echinococcus (Rudolphi, 1801) on St Lawrence Island was noted by the writers in early 1950. Recognition of its unusual host relationships led to an investigation of the ecology of this cestode, E. sibiricensis Rausch & Schiller, 1954. It is the purpose of this paper to report the results of this work, with emphasis on alveolar hydatid disease in man, of which this cestode is the etiologic agent.

Juvenile onset systemic lupus erythematosus: a possible role for vitamin D in disease status and bone health

Purpose: In juvenile onset systemic lupus erythematosus (JoSLE), evidence for the association between vitamin D status, lupus activity, and bone health is very limited and not conclusive. The aim of this study was, therefore, to assess in JoSLE patients the possible relevance of vitamin D deficiency in disease and bone parameters. Methods: Fifty-seven JoSLE patients were initially compared to 37 age, race and body mass index (BMI) -matched healthy controls. The serum concentration of 25 hydroxyvitamin D (25OHD) was determined by radioimmunoassay. Patients with 25OHD deficiency (acurrency sign20 ng/mL) were compared to those with levels > 20 ng/mL. Disease activity was evaluated by SLE Disease Activity Index (SLEDAI). Bone mineral density (BMD) and body composition (BC) were measured using dual-energy X-ray absorptiometry (DXA). Results: 25OHD levels were similar in patients and controls (21.44 +/- 7.91 vs 22.54 +/- 8.25 ng/mL, p = 0.519), regardless of supplementation (65% of patients and none in controls). Thirty-one patients with 25OHD deficiency (acurrency sign20 ng/mL) were further compared to the 26 JoSLE patients with levels > 20 ng/mL. These two groups were well-balanced regarding vitamin D confounding variables: age (p = 0.100), ethnicity (p = 1.000), BMI (p = 0.911), season (p = 0.502), frequency of vitamin D supplementation (p = 0.587), creatinine (p = 0.751), renal involvement (p = 0.597), fat mass (p = 0.764), lean mass (p = 0.549), previous/current use of glucocorticoids(GC) (p = 1.0), immunosuppressors (p = 0.765), and mean current daily dose of GC (p = 0.345). Patients with vitamin D deficiency had higher SLEDAI (3.35 +/- 4.35 vs 1.00 +/- 2.48, p = 0.018), lower C4 levels (12.79 +/- 6.78 vs 18.38 +/- 12.24 mg/dL, p = 0.038), lower spine BMD (0.798 +/- 0.148 vs 0.880 +/- 0.127 g/cm2, p = 0.037) and whole body BMD (0.962 +/- 0.109 vs 1.027 +/- 0.098 g/cm2, p = 0.024). Conclusion: JoSLE vitamin D deficiency, in spite of conventional vitamin D supplementation, affects bone and disease activity status independent of therapy and fat mass reinforcing the recommendation to achieve adequate levels. Lupus (2012) 21, 1335-1342.

Lean diesel technology and human health: a case study in six Brazilian metropolitan regions

OBJECTIVE: Due to their toxicity, diesel emissions have been submitted to progressively more restrictive regulations in developed countries. However, in Brazil, the implementation of the Cleaner Diesel Technologies policy (Euro IV standards for vehicles produced in 2009 and low-sulfur diesel with 50 ppm of sulfur) was postponed until 2012 without a comprehensive analysis of the effect of this delay on public health parameters. We aimed to evaluate the impact of the delay in implementing the Cleaner Diesel Technologies policy on health indicators and monetary health costs in Brazil. METHODS: The primary estimator of exposure to air pollution was the concentration of ambient fine particulate matter (particles with aerodynamic diameters, <2.5 mu m, [PM2.5]). This parameter was measured daily in six Brazilian metropolitan areas during 2007-2008. We calculated 1) the projected reduction in the PM2.5 that would have been achieved if the Euro IV standards had been implemented in 2009 and 2) the expected reduction after implementation in 2012. The difference between these two time curves was transformed into health outcomes using previous dose-response curves. The economic valuation was performed based on the DALY (disability-adjusted life years) method. RESULTS: The delay in implementing the Cleaner Diesel Technologies policy will result in an estimated excess of 13,984 deaths up to 2040. Health expenditures are projected to be increased by nearly US$ 11.5 billion for the same period. CONCLUSIONS: The present results indicate that a significant health burden will occur because of the postponement in implementing the Cleaner Diesel Technologies policy. These results also reinforce the concept that health effects must be considered when revising fuel and emission policies.

Relationship Between Oral Health-Related Quality of Life, Oral Health, Socioeconomic, and General Health Factors in Elderly Brazilians

Objectives To assess the impact of oral health on quality of life in elderly Brazilians and to evaluate its association with clinical oral health measures and socioeconomic and general health factors. Design Cross-sectional study. Setting Population-based cohort study on health, well-being, and aging. Participants Eight hundred fifty-seven participants representing 588,384 community-dwelling elderly adults from the city of Sao Paulo, Brazil. MeasurementS Self-perceived impact of oral health on quality of life was measured using the Geriatric Oral Health Assessment Index (GOHAI), with scores categorized as good, moderate, or poor, indicating low, moderate, and high degrees of negative impact on quality of life, respectively. Results Nearly half of the individuals had good GOHAI scores (44.7% of overall sample, 45.9% of dentate participants, and 43.4% of edentulous participants). In the overall sample, those with poor self-rated general health and a need for dental prostheses were more likely to have poor and moderate GOHAI scores. Individuals with depression were significantly more likely to have poor GOHAI scores. No socioeconomic variables were related to the outcome, except self-perception of sufficient income, which was a protective factor against a poor GOHAI score in dentate participants. Conclusion Moderate and high degrees of negative impact of oral health on quality of life were associated with general health and clinical oral health measures, independent of socioeconomic factors.

LEISURE AND MENTAL HEALTH IN PEOPLE WITH HYPERTENSION: CONVERGENCE IN HEALTH EDUCATION

People with hypertension constantly deal with issues related to mental health due to the psychosocial determinants of this illness, and leisure is an important control strategy. The objective of this study was to promote health education to a group of hypertensive patients, through research-action, based on critical-social pedagogy, and taking into consideration the participants' perception of leisure. Educational activities were conducted and, following, an evaluation was performed regarding the subjects' opinion about the impact of leisure on their lives and mental health. The group perceived leisure as a coping strategy for loneliness and also as a late development of independence; it was also regarded as a means of socialization and as a promotion of mental health. These perceptions revealed two themes: aging, leisure, and chronic disease; and knowledge and leisure experiences. Educational actions, such as group dynamics and discussions, were planned considering these themes with the purpose of providing the necessary conditions for socializing and exchanging experiences.

Metropolitan and regional health planning: dilemmas of the Pact for Health in the Baixada Santista Metropolitan Area, Sao Paulo State, Brazil

This paper focuses on the relationship between metropolitan and regional health planning based on the processes of regionalization and the Pact for Health in the Baixada Santista Metropolitan Area, Sao Paulo State, Brazil. The method used was a case study in two stages, namely during initial implementation of the Pact for Health (2007) and the Regional Administration Committees (CGR) and in 2010. Municipal and regional health systems managers and the director of the Metropolitan Agency were interviewed, and records were analyzed from ten years of meetings of the Regional Inter-Administration Committee and the Regional Development Council. Four issues emerged: financing and infrastructure; health services utilization; inefficiency of the Regional Health Administration's instruments and decision-making levels; and the relationship between different levels in the Administration. Metropolitan health management remained as an underlying issue, appearing only incidentally or tangentially to regional management. Despite some limitations, the CGR has been legitimized as a space for regional health management.

Work organization and the health of bank employees

The Brazilian banking sector has undergone an intense restructuring process and taken a leading position in the incorporation of new technologies and organizational innovations. Computerization in the industry, in association with forms of work organization, has resulted in changes that reflect on the workers' health. Based on the theoretical and methodological frameworks of historical and dialectical materialism, this qualitative study investigates the work conditions of bank employees in order to identify the extent to which changes in work organization interfere with these workers' health. Data were collected through interviews held with 11 bank employees. In addition to physical sickening due to occupational diseases directly related to work intensification, the results also show an increased incidence of mental suffering and a feeling of loss of professional identity. Work-related frustration, instability and concerns related to psychological pressure resulting from the need to achieve goals predominated in the reports.

Lactation stage and udder health status of Santa Ines ewes

FAPESP [2003/08582-7]

Association between parental guilt and oral health problems in preschool children

Parents may feel guilty about their children's oral problems, which can affect their quality of life. The aim of this study was to assess the presence of parental guilt and its association with early childhood caries (EGG), traumatic dental injuries (TDI) and malocclusion (AMT) in preschool children. All 2 to 5 year-old children (N = 305), and their parents, seeking dental care at the University of Sao Paulo Dental School one-week Screening Programme, were asked to participate in the study, and 260 agreed. Children were examined by two calibrated dentists, and their parents answered a socioeconomic and ECOHIS questionnaire; the question on guilt was used as the dependent variable. Regression analyses examined the association between parental guilt and EGG, TDI, AMT and socioeconomic factors. A total of 35.8% of parents felt guilty. This was only associated with caries severity. No association was found between guilt and TDI, AMT or socioeconomic factors. EGG was present in 63.8% of the children; the mean (+/-sd) dmf-t score was 7.29 (+/-2.78). Thus, the number of parents feeling guilty increases with the increase of their children's dental caries severity. Parental guilt is related to caries but is not associated with TDI or AMT.

Relationships between gender, age, family conditions, physical and mental health, and social isolation of elderly caregivers

Background: In an aging population an increasing number of elderly caregivers will be called upon to provide care over a long period, during which time they will be burdened both by caregiving and by the physiological effects of their own aging. Among them there will be more aged male caregivers, who will probably be less prepared than women to become caregivers. The aim of this study was to investigate the relationship between caregivers' gender, age, family income, living arrangements and social support as independent variables, and depressive symptoms, comorbidities, level of frailty, grip strength, walking speed and social isolation, as dependent variables. Methods: 176 elderly people (123 women) were selected from a sample of a population-based study on frailty (n = 900), who had cared for a spouse (79.3%) and/or parents (31.4%) in the past five years (mean age = 71.8 +/- 4.86 years; mean monthly family income in minimum wages = 4.64 +/- 5.14). The study used questionnaires and self-report scales, grip strength and walking speed tests. Results: 65% of participants evaluated caregiving as being very stressful. Univariate analyses of regression showed low family income as a risk factor for depression; being female and low perceived social support as a risk for comorbidities; being 80 years of age and above for low grip strength; and being male for social isolation indicated by discontinuity of activities and social roles. In multivariate analyses of regression, poverty arose as a risk factor for depression and being female for comorbidities. Conclusions: Gender roles, age, income and social support interacted with physical and emotional health, and with the continuity of social participation of elderly caregivers. Special attention must be given to male caregivers.

Bioethics and Mental Health: The Rights of Patients With a Disorder

Bioethics can be included in the context of psychiatric patients' recovery of dignity and rights, creating a therapeutic interface of social rehabilitation, respect and closeness between professionals and the treated persons. The completion of the analysis of the facts occurred by reviewing 22 articles dated between 1999-2011, from a prior reading, selecting the ones that mention bioethics and mental health. Before the Psychiatric Reform, often, a lack of commitment to the mentally ill was noticed, isolating the patient from a social life. Before the Psychiatric Reform, often, a lack of commitment to the mentally ill was noticed by isolating the patient from a social life. After the Reform, the person with mental illness began to receive a more attentive care. It can be concluded that the Reform tried to bring life to those who had no respect and attention, these patients who needed to be included in a social and urban interaction.