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

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

A produção das desigualdades: análise da relação entre trabalho infantil e indicadores sociais

The International Labor Organization (OIT) estimates that there are around 118 million children subjected to child labor around the world. In Brazil, there are 3.5 million workers aged between 5 and 17. This exploitation practice constitutes a serious social problem, including of Public Health, since these workers are exposed to a wide range of risks, such as those related to health, physical integrity and even to life, which may cause them to become sick adults and/or interrupt their lives prematurely. Therefore, this research aims to investigate the relationship between the frequency of child labor in the age group of 10 to 13 years and some socio-economic indicators. It is a quantitative research in an ecological study whose levels of analysis are the Brazilian municipalities grouped in 161 regions, defined from socioeconomic criteria. The dependent variable of this study was the prevalence of child labor in the age group of 10 to 13 years. The independent variables were selected after a correlation between the 2010 Census of child labor in the age group of 10 to 13 years and secondary data had been conducted, adopting two main independent variables: funds from the Family Allowance Program (PBF) per 1,000 inhabitants and Funds from the Child Labor Eradication Program (PETI) per a thousand inhabitants. Initially, it was conducted a descriptive analysis of the variables of the study, then, a bivariate analysis, and the correlation matrix was built. At last, the Multiple Linear Regression stratified analysis was performed. The results of this survey indicate that public policies , like the Bolsa Familia Program Features per 1000 inhabitants and Resources Program for the Eradication of Child Labour to be allocated to municipalities with HDI < 0.697 represent a decrease in the rate of child labor ; These programs have the resources to be invested in municipalities with HDI > = 0.697 have no effect on the rate of child labor. Other adjustment variables showed significance, among these the municipal Human Development Index (IDH), years of schooling at 18 years of age, illiteracy at 15 years of age or more, employees without employment contract at 18 years of age and the Gini Index. It is understood that the child labor issue is complex. The problem is associated, although not restricted to, poverty, the social exclusion and inequality that exist in Brazil, but other factors of cultural and economic nature, as well as of organization of production, also account for its aggravation. Fighting child labor involves a wide intersectoral articulation, shared and integrated with several public policies, among them health, sports, culture, agriculture, labor and human rights, with a view to guaranteeing the integrality of the rights of children and adolescents in situation of labor and of their respective families

A incorporação de preceitos ambientais no sistema de gestão de resíduos sólidos do município de João Câmara - RN Brasil

The reality points to the global environmental sustainability as the only viable option for addressing the crisis at hand. The move towards sustainability calls for the generation / evaluation systems in their direction, through the incorporation of environmental requirements and in line with the National Policy on Solid Waste. Therefore, the proposed research supports the importance of social and environmental vision, complementing the technical view, the system for management of solid waste from East London, which is a municipality that has a system whose inadequacies are configured in environmental risk and health. Therefore, by observing, applying the model of sustainability indicators and content analysis of interviews, this research proposes to investigate the principles of sustainability and social participation are presented and what is the perception of risk about the inadequacies in the system. The results confirmed the hypotheses of the study and draw a picture of worrying data, such as very unfavorable indicators of sustainability, lack of channels of participation, uncommitted investments with the management system, devaluation of the collector of waste and differing perceptions about the risk by making actors act in isolation. This worrying situation is eased by the appearance of a series of elements are configured as opportunities for the integration of environmental principles in the system. And despite the inability of managers to participate in the research system, yet it behaves as an opportunity to implement public policies in the area of solid waste such as: the preparation of the municipal waste, the institutionalization of selective collection and organization of cooperative with the support of companies present in the city and educational institutions as the Federal Institute. The research is an opportunity for the implementation of policies in the area of solid waste and will collaborate with the building instruments for the quality of life of residents, for the socioeconomic conditions of collectors and the move towards a sustainable society

Coeficientes de incidência do dengue e sua relação com os diferenciais intra-urbanos segundo condições de vida no município do Natal, Rio Grande do Norte

This study sprang from the hypothesis that spatial variations in the morbidity rate for dengue fever within the municipality of Natal are related to intra-city socioeconomic and environmental variations. The objective of the project was to classify the different suburbs of Natal according to their living conditions and establish if there was any correlation between this classification and the incidence rate for dengue fever, with the aim of enabling public health planners to better control this disease. Data on population density, access to safe drinking water, rubbish collection, sewage disposal facilities, income level, education and the incidence of dengue fever during the years 2001 and 2003 was drawn from the Brazilian Demographic Census 2000 and from the Reportable Disease Notification System -SINAN. The study is presented here in the form of two papers, corresponding to the types of analysis performed: a classification of the urban districts into quartiles according to the living conditions which exist there, in the first article; and the incidence of dengue fever in each of these quartiles, in the second. By applying factorial analysis to the chosen socioeconomic and environmental indicators for the year 2000, a compound index of living condition (ICV) was obtained. On the basis of this index, it was possible to classify the urban districts into quartiles. On undertaking this grouping (paper 1), a heterogeneous distribution of living conditions was found across the city. As to the incidence rate for dengue fever (paper 2), it was discovered that the quartile identified as having the best living conditions presented incidence rates of 15.62 and 15.24 per 1000 inhabitants respectively in the years 2001 and 2003; whereas the quartile representing worst living conditions showed incidence rates of 25.10 and 10.32 for the comparable periods. The results suggest that dengue fever occurs in all social classes, and that its incidence is not related in any evident way to the chosen formula for living conditions

Different nutritional-state indicators of HIV-positive individuals undergoing antiretroviral therapy

This study aimed at learning about the nutritional profile of HIV-positive individuals undergoing antiretroviral therapy and at comparing the performance of nutritional-state indicators. A transversal study was performed on 94 patients attending the Tropical Diseases Outpatient Hospital of Botucatu Medical School (FMB)-UNESP. The body mass index (BMI) and the classification by Papini-Berto (PB) were used to evaluate nutritional state, aiming at detecting malnutrition and obesity. The waist-to-hips ratio (W/HR) and waist circumference (WC) were adopted for identification of abdominal obesity and lipodystrophy. According to BMI, most of the individuals were eutrophic, followed by 30.9% overweight and 6.4% malnourished. By using the PB classification, the frequency of malnourished increased (22.3%). The analysis of the PB classification in relation to BMI indicated that the former presented high sensitivity and good specificity for malnutrition diagnosis, namely 100% and 83%, respectively. The prevalence of abdominal obesity was 7.44% according to WC, and a higher prevalence (38.3%) was observed when taking W/HR into account. There was significant positive association between nutritional diagnosis according to PB and T CD4(+) lymphocyte. The results support the use of PB classification for malnutrition detection as well as that of BMI and W/HR for overweight and fat redistribution.

Rotavirus gastroenteritis in a children's hospital specialized in craniofacial malformations

This study aimed to verify the relationship between acute diarrhea provoked by rotavirus and different indicators of craniofacial malformations. In the Hospital for Rehabilitation of Craniofacial Anomalies, 8,724 children with cleft lip and cleft palate were divided into the following groups: acute diarrhea and infection due to rotavirus (C1, n = 62), acute diarrhea (C2, n = 153) and without acute diarrhea (C3, n = 8,509). In C1, 29.03% of the cases consisted of hospital infections associated with the hospitalization period while 38.71% of the patients were aged less than six months. The percentage of children not having breastfed was significantly higher in acute diarrhea groups. Additionally, there was a seasonal prevalence of rotavirus infection between May and October. Finally, the present findings indicate that rotavirus is a predominant etiological agent for gastroenteritis in children with craniofacial malformations. Moreover, among infants younger than six months of age, type of craniofacial malformation, breastfeeding difficulty, socioeconomic level and longer hospitalization period appear to contribute to higher infection morbidity.

Socioeconomic and demographic profile of leprosy carriers attended in nursing consultations

A hanseníase é doença infecto-contagiosa para a qual, além das condições individuais, outros fatores relacionados aos níveis de endemia e às condições socioeconômicas desfavoráveis influem no risco de adoecer. Objetivou-se reconhecer o perfil socioeconômico e demográfico e o grau de incapacidade instalado dos portadores de hanseníase, atendidos no Centro de Saúde Escola de Botucatu, São Paulo, Brasil. Fizeram parte do estudo 37 pacientes. Os dados foram obtidos por meio do instrumento de consulta de enfermagem. Os resultados mostraram predominância de indivíduos com união estável (78%), brancos (92%), com idade entre 30 e 49 anos (51%), com baixo nível de escolaridade e com renda familiar per capita menor que um salário mínimo. Mais de um terço dos pacientes investigados (35%) apresentavam algum grau de incapacidade física. A associação do baixo perfil socioeconômico com a presença de incapacidades físicas imprime maior vulnerabilidade a essa população, podendo impactar negativamente a sua qualidade de vida.

Associations between healthy eating patterns and indicators of metabolic risk in postmenopausal women

Background: Since human diets contain many components that may work synergistically to prevent or promote disease, assessing diet quality may be informative. The purpose of this study was to investigate the association between quality diet, by using Healthy Eating Index (HEI), and metabolic risk indicators in postmenopausal women.Methods: This cross-sectional study included a total of 173 Brazilian women, aged 45-75 years, seeking healthcare at a public outpatient center. Food consumption assessed by 24 h-recall food inquiry was used to calculate HEI scores: >80 implied diet good, 80-51 diet needed improvement, and <51 diet poor. Anthropometric data included: body mass index (BMI = weight/height(2)), waist-circumference (WC), body fat (%BF) and lean mass (%LM). Data on total cholesterol (TC), high density lipoprotein cholesterol (HDLC), low density lipoprotein cholesterol (LDLC), and triglycerides (TG) were also collected. Fisher's Exact test, and logistic regression method (to determine odds ratio, OR) were used in the statistical analysis.Results: Overweight and obesity were observed in 75.7% of the participants. Excessive %BF (> 35%) was observed in 56.1%, while %LM was reduced (<70%) in 78.1%. WC was elevated (= 88 cm) in 72.3%. Based on HEI values, diet quality was good in 3% (5/173), needed improvement in 48.5% (84/173), and was poor in 48.5% (84/173) of the cases. In this group, 75% of women had high intakes of lipids (> 35%), predominantly saturated and monounsaturated fat. on average, plasma TC, LDLC, and TG levels were higher than recommended in 57.2%, 79.2% and 45.1% of the women, respectively, while HDLC was low in 50.8%. There was association between HEI scores and the %BF that it was higher among women with HEI score < 80 (p = 0.021). There were not observed significant risk associations between HEI and lipid profile.Conclusion: Among the Brazilian postmenopausal women attending a public outpatient clinic, diet was considered to need improvement or to be of poor quality, attributed to high saturated fat ingestion, which probably caused a negative impact on metabolic risk indicators, namely body composition.

Association between anthropometric indicators of body fat and metabolic risk markers in post-menopausal women

Objective. to evaluate anthropometric indicators of body fat and their association with metabolic risk markers in postmenopausal women.Methods. A cross-sectional study with 80 Brazilian women (40-70 years) was carried out. Body mass index (BMI = weight/height(2)), waist circumference (WC) and waist-to-hip ratio (WHR) were obtained for anthropometric evaluation. Trunk fat mass (TFM) was measured by dual-energy X-ray absorptiometry. The following metabolic variables were evaluated: total cholesterol (TC), HDL, LDL, triglycerides (TG), as well as glycemia and insulin to determine insulin resistance (HOMA-IR).Results. Overweight and obesity were observed in 81% of the women. Values of WC >88 cm were observed in 68.5% of the women. on average, TC, LDL and TG levels were above normal levels in 60, 50 and 42.5% of the women, respectively; and HDL was normal in 82.5%. IR was observed in 37.5% of the women. Positive correlations were found between anthropometric indicators and TFM (P < 0.05). WC was most correlated with TFM (r = 0.92), followed by BMI (r = 0.88) and by WHR (r = 0.48; P < 0.05). All anthropometric indicators and TFM showed significant negative correlations with HDL and significant positive correlations with HOMA-IR (P < 0.05). Only WHR was significantly associated with dysglycemia (R(2) = 12%), hypertriglyceridemia (R(2) = 17%) and decreased HDL (R(2) = 27%). WC was significantly associated with HOMA-IR (R(2) = 34%).Conclusion. WC and WHR are anthropometric measures that showed strong correlation with TFM and with metabolic risk markers in postmenopausal women.

Ten-week lifestyle changing program reduces several indicators for metabolic syndrome in overweight adults

We aim to investigate the effectiveness of a 10-week lifestyle intervention focusing on physical activity and high fiber intake for reducing indicators for metabolic syndrome in overweight-obese individuals. A prospective study of 50 overweight (OW) adults (22 in the general educational group - G1; 28 in the high fiber nutrition group - G2) was performed. Both groups were offered dietary counseling and supervised exercise. Clinical, anthropometric, dietary and plasma biochemical tests were performed at baseline - time 0 (T0) and after 10 weeks - time 1 (T1). Both groups improved their dietary quality, but only G2 presented higher intake of fruit and vegetables (servings/day), higher plasma beta-carotene levels and a 24% reduction of MetS incidence. Additionally G2 showed greater reductions in body fat (4%), and waist circumference (7%), obesity class III (2%) and obesity class II (14%) rate. Lifestyle intervention, including a high dietary fiber intake, improved healthy eating index and decreased body fat composition and plasma lipid concentrations leading to MetS incidence reduction.

Prevalência do aleitamento materno

OBJETIVO: Avaliar os indicadores de aleitamento materno em consultórios particulares e centros de saúde no município de Lins, SP, e comparar a prevalência de aleitamento materno exclusivo dessa região com a encontrada em outras pesquisas. MÉTODOS: Estudo de corte transversal com amostra aleatória de 255 crianças de quatro a doze meses de idade, estratificada por sexo, condição socioeconômica e escolaridade dos pais. Foram avaliados os indicadores de aleitamento materno em dois grupos de crianças: as acompanhadas em consultórios particulares e as acompanhadas em centros de saúde. Foram utilizados questionários respondidos pelos responsáveis. Os dados desta pesquisa foram comparados aos de outros estudos. RESULTADOS: Apesar de haver diferenças significativas nas condições de renda, estrato social e escolaridade dos pais, não houve diferença significativa nos índices de aleitamento materno entre os dois grupos. No grupo total, a prevalência de aleitamento materno exclusivo aos quatro meses foi de 61,1% e a mediana de aleitamento materno exclusivo foi de 120 dias. Os resultados foram superiores aos dos demais estudos consultados. CONCLUSÃO: Os resultados mostraram diferenças relacionadas às condições socioeconômicas, porém, os índices de aleitamento materno foram semelhantes entre os dois grupos. Os resultados de aleitamento materno exclusivo foram superiores aos das demais pesquisas.

Candida spp. biotypes in the oral cavity of school children from different socioeconomic categories in Piracicaba - SP, Brazil

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Stable carbon (delta(13)C) and nitrogen (delta(15)N) isotopes as natural indicators of live and dry food in Piaractus mesopotamicus (Holmberg, 1887) larval tissue

This study proposed the use of the stable isotope technique to track the type of food utilized by pacu Piaractus mesopotamicus larvae during their development, and to identify the moment when the larvae start using nutrients from the dry diet by retaining its carbon and nitrogen atoms in their body tissues. Five-day-old pacu larvae at the onset of exogenous feeding were fed Artemia nauplii or formulated diet exclusively; nauplii+formulated diet during the entire period; or were weaned from nauplii to a dry diet after 3, 6 or 12 days after the first feeding. delta(13)C and delta(15)N values for Artemia nauplii were -15.1 parts per thousand and 4.7 parts per thousand, respectively, and -25.0 parts per thousand and 7.4 parts per thousand for the dry diet. The initial isotopic composition of the larval tissue was -20.2 parts per thousand and 9.5 parts per thousand for delta(13)C and delta(15)N respectively. Later, at the end of a 42-day feeding period, larvae fed Artemia nauplii alone reached values of -12.7 parts per thousand and 7.0 parts per thousand for delta(13)C and delta(15)N respectively. Larvae that received the formulated diet alone showed values of -22.7 parts per thousand for delta(13)C and 9.6 parts per thousand for delta(15)N. The stable isotope technique was precise, and the time at which the larvae utilized Artemia nauplii, and later dry diet as a food source could be clearly defined.