A saúde na percepção do adolescente

Na fase da adolescência, o indivíduo experimenta os melhores índices de saúde, os quais podem ser mantidos e/ou melhorados, dependendo da percepção e valorização dos mesmos, influenciando na sua qualidade de vida. O estudo avaliou a opinião de adolescentes (n=493) da Fundação Mirim do Município de Araçatuba - SP, quanto à saúde geral e bucal, bem como sua percepção sobre elas, por meio questionário semiestruturado, durante o ano letivo de 2006, já que os mesmos possuem acesso à atenção à saúde bucal e palestras sobre saúde. Dentre os entrevistados 34,5% conceituaram a saúde como coisa ou algo que precisa(mos) cuidar; 26,6%, como bem-estar; 18,1%, como a própria existência; e 14,5%, como ausência de doença. em relação aos conceitos de saúde bucal, 68,4% definiram como higiene; 16,2%, como aparência; e 15,5%, como ausência de doenças bucais. A percepção desses jovens quanto a sua saúde em geral foi para 46,5%, ótima, e 44,1%, boa, enquanto que a da sua saúde bucal foi para 53,6%, boa, e 24%, ótima. Pode-se concluir que os adolescentes têm uma ideia tanto sobre saúde geral como saúde bucal, porém a classificação é menor no que tange à saúde bucal, pois envolve aspectos afetivos, estéticos e sociais. Ademais, percebe-se a necessidade de programas educativo-preventivos direcionados a esse grupo.

Percepção das condições de saúde bucal por gestantes atendidas em uma unidade de saúde no município de Araraquara, São Paulo, Brasil

OBJETIVOS: avaliar a percepção das condições de saúde bucal de um grupo de gestantes, através da aplicação do índice General Oral Health Assessment Index (GOHAI). MÉTODOS: participaram do estudo 53 gestantes que freqüentavam uma Unidade Básica de Saúde em Araraquara, São Paulo. Foi aplicado um questionário contendo questões do índice GOHAI, questões sobre a autopercepção das condições bucais e sobre as características sócio-demográficas. Por meio dos testes não-paramétricos Mann-Whitney e Kruskall-Wallis, foram determinados a associação das variáveis sociais e de autopercepção com o índice GOHAI. RESULTADOS: a percepção das condições bucais, medida pelo índice GOHAI, foi positiva e apresentou um valor médio de 31,6. Os dados subjetivos mostram que apenas 12,0% das gestantes classificaram sua condição bucal como ruim, a maioria declarou nenhum problema dentário, embora 58,7% tenha relatado distúrbios gengivais. As questões como dor e/ou desconforto foram as mais percebidas pelas gestantes. CONCLUSÕES: as gestantes fizeram uma avaliação positiva de sua condição bucal, estando o índice GOHAI associado a variáveis relacionadas à autopercepção. Tal índice pode ser aplicado em grupos populacionais como as gestantes, possibilitando medidas educativas e/ou preventivas direcionadas às suas reais necessidades.

Autopercepção das condições de saúde bucal por idosos

OBJETIVO: Avaliar a autopercepção das condições de saúde bucal por idosos e analisar os fatores clínicos, subjetivos e sociodemográficos que interferem nessa percepção. MÉTODOS: Participaram do estudo 201 pessoas, dentadas, com 60 anos ou mais, funcionalmente independentes, que freqüentavam um centro de saúde localizado em Araraquara, SP, Brasil. Foi aplicado questionário com questões sobre as características sociodemográficas da amostra, a autopercepção da condição bucal e o índice Geriatric Oral Health Assessment Index (GOHAI). Realizou-se exame clínico para determinar a prevalência das principais doenças bucais. Foram usados testes estatísticos para determinar a associação das variáveis sociodemográficas e clínicas e do índice GOHAI com a autopercepção da condição bucal e a identificação dos preditores da auto-avaliação. RESULTADOS: O exame clínico revelou grande prevalência das principais doenças bucais, apesar de 42,7% das pessoas avaliarem sua condição bucal como regular. As variáveis associadas à auto-avaliação foram: classe social, índice de GOHAI, dentes cariados e indicados para extração. A análise multivariada mostrou que os preditores da auto-avaliação foram o GOHAI, os dentes com extração indicada e o índice Community Periodontal Index and Treatment Needs. Esses preditores explicaram 30% da variabilidade da auto-avaliação. CONCLUSÕES: Concluiu-se que a percepção da saúde bucal teve pouca influência nas condições clínicas, mostrando ser necessário desenvolver ações preventivas e educativas para a população.

Reproducibility and validity of self-perceived oral health conditions

The reproducibility and validity of self-perceived periodontal, dental, and temporomandibular joint (TMJ) conditions were investigated. A questionnaire was applied in interview to 200 adults aged from 35 to 44, who were attending as casual patients at Araraquara School of Dentistry, Sauo Paulo State University, Sauo Paulo, Brazil. Clinical examination was based on the guidelines of the World Health Organization manual. The interview and the clinical examination were performed in two occasions, by a calibrated examiner. Reproducibility and validity were, respectively, verified by kappa statistics (kappa) and sensitivity (Sen) and specificity (Spec) values, having clinical examination as the validation criterion. The results showed an almost perfect agreement for self-perceived TMJ (kappa=0.85) and periodontal conditions (kappa=0.81), and it was substantial for dental condition (kappa=0.69). Reproducibility according to clinical examination showed good results (kappa=0.73 for CPI index, kappa=0.96 for dental caries, and kappa=0.74 for TMJ conditions). Sensitivity and specificity values were higher for self-perceived dental (Sen=0.84, Spec=1.0) and TMJ conditions (Sen=1.0, Spec=0.8). With regard to periodontal condition, specificity was low (0.43), although sensitivity was very high (1.0). Self-perceived oral health was reliable for the examined conditions. Validity was good to detect dental conditions and TMJ disorders, and it was more sensitive than specific to detect the presence of periodontal disease.

TMD and GOHAI indices of Brazilian institutionalised and community-dwelling elderly

Considering the controversy in the literature regarding several aspects of temporomandibular dysfunction (TMD) in elderly populations and the absence of reliable data on elderly Brazilians in this field, this study consisted of an evaluation of TMD prevalence and the self-perception of oral health among institutionalised and community-dwelling elderly in Sao JosE dos Campos, Brazil.Two hundred and fifteen community-dwelling and 185 institutionalised elderly people were evaluated by the Helkimo anamnestic (Ai) and clinical dysfunction (Di) indices and answered a questionnaire using the Geriatric Oral Health Assessment Index (GOHAI).The major prevalence of TMD symptoms was for the Ai0 (symptom-free) group (69.5%), while the major prevalence of clinical signs was for the DiI (mild) group (56%). Women presented a higher AiII classification than men (chi(2) test, p = 0.049). Community-dwelling elderly presented a significantly lower Ai0 classification than the institutionalised ones (Two ratios equality test, p < 0.001). There was no relationship between the institutionalised status and the clinical dysfunction index for Di0 and DiIII classification (Two ratios equality test, p = 0.194 and 0.535 respectively). The institutionalised elderly presented greater (One-way anova = 0.005) self-perception of oral health (33.45) than did the community-dwelling group (32.66). There were only weak Pearson's correlations among the anamnestic (-33.0%) or clinical (-14.7%) findings by the TMD and GOHAI indices. Symptom-free (Ai0) institutionalised elderly presented better scores in all GOHAI dimensions and elderly representing an absence of clinical TMD signs (Di0) presented higher GOHAI physical dimension scores in both groups.The prevalence of TMD symptoms among this sample of elderly individuals was relatively low, self-perception of oral health was reasonable and a weak, inverse correlation was found between TMD signs and symptoms and elderly self-perception of oral health measured by the GOHAI index.

Open urban spaces quality: A study in a historical square in Bath - UK

The quality of open urban spaces is very important for urban vitality. Nowadays urban designers have to face the great challenge of designing urban spaces able to respond to people's need for liveable spaces. The success of these spaces depends on various aspects and the microclimatic condition has been recognized as one of the most influential. However, studies on thermal comfort in open space have shown that the user's thermal sensation does not depend only on microclimate parameters but also on other local qualitative aspects. Thus, environmental quality evaluation of successful public spaces can contribute to understand this issue. This paper focuses on a case study regarding Queen Square's environmental quality, a public space of historical importance in Bath-UK. The first stage of the research, a study on local characteristics and people observations, allowed a preliminary evaluation of the space performance, their social aspects, while it characterized and quantified the hourly variation of the space use in different days and seasons. In the second stage, short microclimatic surveys were carried out simultaneously with a perception survey through a questionnaire. The results show the strong vitality of the square and socioenvironmental significance, not only for its location in the urban context, but also for its historical value. The environmental quality of the square contributes to the users' sensation of comfort even in adverse climatic conditions. This research is part of a project that aims to investigate the impact of the environmental stimuli in the use of open spaces and intend to develop design strategies that aim to maximise the use of open spaces in different weather conditions.

Globalización, integración y cohesión social: el caso MERCOSUR

Incluye Bibliografía

Integración económica y cohesión social: lecciones aprendidas y perspectivas

Incluye Bibliografía

La importancia de la cohesión social en la inserción internacional de América Latina

Incluye Bibliografía

El financiamiento solidario de la protección social: condición indispensable para un pacto de cohesión social en América Latina

Incluye Bibliografía

Correlation between oral health perception and clinical factors in a Brazilian community

Objective: The aim of this study was to analyse associations between self-perception of oral health and relevant clinical, personal and socio-demographic factors in a Brazilian community. Material And Methods: Urban adults living in a city in southern Brazil were interviewerd and examined. Individuals with acute pain and who needed multiple extractions of teeth were excluded. Self-perception and the Oral Health Impact Profile (OHIP-14) were applied to measure the impact of oral conditions on the quality of life. Socio-demographic and clinical indicators were also analysed. Results: The clinical examination revealed a high dental caries experience (DMFT = 18.9) and a high prevalence of periodontal disease. Oral condition was considered normal by 42% of respondents. The variables associated with the OHIP-14 were: education, age, self-assessment, dental caries and the DMFT index. Conclusions: Self-perception of oral health was associated with OHIP-14 and the clinical indicators had low influence in the self-perception. Therefore, the development of educational initiatives and preventive strategies for the adult population is recommended. © BASCD 2011.

Por un contrato de cohesión social": apuntes exploratorios"

Incluye Bibliografía

Globalización, integración y cohesión social: el caso MERCOSUR

Incluye Bibliografía

Social and economic problems in Cuba during the crisis and subsequent recovery

Includes bibliography

Health-related quality of life and depression in patients with dentofacial deformity

Introduction: Patients with dentofacial deformities present difficulties at work and in social adaptation. At the same time, they often appear depressed, and as a consequence, the psychosocial aspects of surgery play an important role. The aim of this study was to investigate the effects that depression causes in the quality of life of patients with dentofacial deformity. Material and methods: Filthy patients were recruited 1 year before undergoing orthognathic surgery and correlated oral and general health with the presence and absence of depression. In order to accomplish this, these patients received an adapted questionnaires of quality of life and Beck Depression Inventory to fill out. Fisher's test was applied, with a significance level of 5 %. Intercooled Stata version 9.0 was used to analyze data. Results: Among the eight domains of quality of life, there were three associated with depression status: vitality (p < 0.001), social aspects (p = 0.011), and mental health (p = 0.008). Discussion: There is growing interest in the impact of dentofacial deformity conditions on patients' quality of life. The scientific literature has discussed the social aspects of these deformities and showed that untreated patients had low self-esteem and suffered social restrictions before making the orthodontic and surgical treatments. This study concluded that the depression interferes significantly in vitality, social aspects of the individual, and mental health and, at the same time, emphasizes that the orthognathic surgery aims to not only restore esthetics and function to the patient but also improve the quality of life. © 2012 Springer-Verlag.