Self-rated oral health and associated factors in Brazilian elders

Objective: Self-rating provides a simple direct way of capturing perceptions of health. The objective of this study was to estimate the prevalence and associated factors of poor self-rated oral health among elders. Methods: National data from a cross-sectional population-based study with a multistage random sample of 4786 Brazilian older adults (aged 65-74) in 250 towns were analysed. Data collection included oral examinations (WHO 1997) and struct-ured interviews at elderly households. The outcome was measured by a single five-point-response-scale question dichotomized into `poor` (fair/poor/very poor) and `good` (good/very good) self-rated oral health. Data analyses used Poisson regression models stratified by sex. Results: The prevalence of poor self-rated oral health was 46.6% (95% CI: 45.2-48%) in the whole sample, 50.3% (48-52.5) in men and 44.2% (42.4-46) in women. Higher prevalence ratios (PR) were found in elders reporting unfavourable dental appearance (PR = 2.31; 95% CI: 2.02-2.65), poor chewing ability (PR = 1.64; CI: 1.48-1.8) and dental pain (PR = 1.44; CI: 1.04-1.23) in adjusted analysis. Poor self-perception was also associated with being men, black, unfavourable socioeconomic circumstances, unfavourable clinical oral health and with not using or needing a dental prosthesis. Conclusion: Assessment and understanding of self-rated oral health should take into account social factors, subjective and clinical oral symptoms.

An extension of the concept of gradient semigroups which is stable under perturbation

In this article we introduce the concept of a gradient-like nonlinear semigroup as an intermediate concept between a gradient nonlinear semigroup (those possessing a Lyapunov function, see [J.K. Hale, Asymptotic Behavior of Dissipative Systems, Math. Surveys Monogr., vol. 25, Amer. Math. Soc., 1989]) and a nonlinear semigroup possessing a gradient-like attractor. We prove that a perturbation of a gradient-like nonlinear semigroup remains a gradient-like nonlinear semigroup. Moreover, for non-autonomous dynamical systems we introduce the concept of a gradient-like evolution process and prove that a non-autonomous perturbation of a gradient-like nonlinear semigroup is a gradient-like evolution process. For gradient-like nonlinear semigroups and evolution processes, we prove continuity, characterization and (pullback and forwards) exponential attraction of their attractors under perturbation extending the results of [A.N. Carvalho, J.A. Langa, J.C. Robinson, A. Suarez, Characterization of non-autonomous attractors of a perturbed gradient system, J. Differential Equations 236 (2007) 570-603] on characterization and of [A.V. Babin, M.I. Vishik, Attractors in Evolutionary Equations, Stud. Math. Appl.. vol. 25, North-Holland, Amsterdam, 1992] on exponential attraction. (C) 2009 Elsevier Inc. All rights reserved.