Access to Oral Health Actions According to Social and Individual Determinants

Abstract Objective: To investigate the socioeconomic, demographic and health needs that influence the access to oral health actions. Material and Methods: The sample consisted of 609 individuals who lived in areas covered by the Family Health Strategy in a city of the Northeast of Brazil. All individuals living in areas covered by the FHS with age equal to or higher than six years were included. Data analysis included descriptive, bivariate and multivariate statistics using decision-tree based Chi-squared automatic interaction detection (CHAID). Results: Most participants were female, aged 25-34 years, ranging in age from 6 to 87 years. It was evidenced that, among the studied variables, the most relevant for understanding the access to oral health actions were: age (p<0.001), educational level (p-value in Node 1 = 0.009; p-value in Node 7 = 0.005) and self-perception of oral health (p=0.001). Conclusion: The results suggest that access to oral health actions is influenced by several social and individual factors, and it is marked by inequalities that favor individuals with higher educational level, better self-perception of oral health and lower age groups.

Acesso aos serviços de saúde bucal em Campina Grande/Paraíba: um estudo de série temporal / Oral health services access in Campina Grande/Paraíba: a time series study

Objetivo:Este estudo avaliou o acesso aos serviços odontológicos em áreas cobertas pela Estratégia Saúde da Família em Campina Grande, Paraíba, comparando as séries temporais dos anos de 2009 e 2014. Métodos: Tratou-se de um estudo quantitativo, analítico, com desenho do tipo transversal, de base populacional, do seguimento de dois estudos, com dados primários coletados prospectivamente, longitudinal ou de seguimento. O estudo teve como variável dependente o acesso a saúde bucal, e no grupo de variáveis independentes encontram-se os fatores sociodemográficos. A análise dos dados foi realizada através do SPSS 18.0, em duas etapas: uma descritiva e outra analítica. Na primeira foram feitas as distribuições de frequência das variáveis quantitativas, na segunda foram testadas as associações, utilizando-se o teste qui quadrado de Pearson. Para todas as análises foi considerado significante o nível de 5% (p < 0,05). Resultados: Os fatores sociodemográficos associados ao acesso no estudo de 2009 foram: idade, estado civil, renda do respondente e escolaridade. Em 2014, além desses, esteve associada a renda familiar. Conclusão: Constata-se que o acesso aos serviços odontológicos não ocorre de forma igualitária, não sendo a população de baixa renda a que mais se beneficia, indicando, pois, uma lacuna na equidade do acesso.

Aim:This study evaluated the access to dental services in areas covered by the Family Health Strategy in Campina Grande, Paraíba, Brazil, comparing the time series of the years 2009 and 2014. Methods: This was a quantitative, analytical study with a population-based cross-sectional design, following two studies, with prospectively collected, longitudinal, or follow-up primary data. The study had access to oral health as the dependent variable, and socio-demographic factors in the group of independent variables. Data analysis was performed using SPSS 18.0, in two steps: one descriptive and one analytical. In the first, frequency distributions of quantitative variables were made, while in the second, associations were tested using Pearson's chi-square. For all analyzes, a level of 5% (p <0.05) was considered significant. Results: The socio-demographic factors associated with access in the 2009 study were: age, marital status, respondent income, and education. In 2014, besides these, the study was associated with family income. Conclusion: It appears that access does not occur equally, and it is not the low-income population that benefits most, thus indicating a gap in equity of access.

Atitudes e práticas de profissionais atuantes na Estratégia Saúde da Família quanto à abordagem aos usuários de drogas no município de Campina Grande, Paraíba, Brasil / Attitudes and practices of professionals who working in the Family Health Strategy regarding the approach to drug users in the municipality of Campina Grande. Paraíba. Brazil

Resumo O objetivo deste estudo foi avaliar as atitudes e as práticas dos profissionais da Estratégia Saúde da Família (ESF) quanto à abordagem aos usuários drogas no município de Campina Grande, Paraíba. Tratou-se de um estudo transversal e exploratório realizado com 126 médicos, enfermeiros e dentistas da Atenção Primária à Saúde (APS). As variáveis investigadas foram relacionadas a dados sociodemográficos, atuação profissional, atitudes e práticas sobre a abordagem aos usuários de drogas de acordo com o Plano Integrado de Enfrentamento ao Crack e outras Drogas. Foi realizada estatística descritiva e multivariada por meio da Análise de Correspondência Múltipla (ACM). A maioria dos profissionais era do sexo feminino (88,9%) e relatou questionar apenas às vezes quanto ao uso de drogas durante a anamnese (53,2%). Baseando-se na ACM, as variáveis com maior poder discriminatório para a dimensão 1 foram: tempo de formado (0,776), tempo de trabalho na APS (0,688), faixa etária (0,656); enquanto que para a dimensão 2 foram: categoria profissional (0,383) e se conhece os usuários de drogas em sua área de abrangência (0,166). Existem diferenças importantes nas atitudes e nas práticas acerca da abordagem dos usuários de drogas entre os profissionais.

Abstract The aim of this study was to evaluate the attitudes and practices of professionals of the Family Health Strategy regarding the approach to drug users in the municipality of Campina Grande. Paraíba. The cross-sectional and exploratory study carried out with 126 doctors. nurses and dentists of Primary Health Care (PHC). Variables investigated were related to sociodemographic data. professional profile. attitudes and practices about the approach to drug users according to the Integrated Plan to Confront Crack and Other Drugs. Descriptive and multivariate statistics were performed through Multiple Correspondence Analysis (MCA). Most professionals were female (88.9%) and reported questioning only sometimes about the use of drugs during the anamnesis (53.2%). Based on MCA results. variables with the greatest discriminatory power for dimension 1 were: training time (0.776). working time in the PHC (0.688). age group (0.656); while for dimension 2 were: professional category (0.383) and knowledge of drug users in their coverage area (0.166). There are important differences in attitudes and practices about the approach of drug users among professionals.

Access to Oral Health Services in Areas Covered by the Family Health Strategy, Paraíba, Brazil

Objective: To evaluate access to oral health services and associated factors in areas covered by the Family Health Strategy. Material and Methods: This is a populationbased study with a systematic random sample of 759 individuals aged ≥ 06 years of a municipality in northeastern Brazil. Data on socio-economic and demographic conditions, tooth pain severity in the last six months and issues related to access to oral health services were collected. Data were analyzed using Pearson's chi-square test and Poisson regression analysis, considering 5% significance level. All tests were performed using the Statistical Package for Social Sciences software (SPSS) version 18.0. Results: 61.7% of individuals had access to dental services, 53.5% of them in the public sector. Through Poisson multivariate regression, individuals more likely to have full access were students (PR: 3.085, 95% CI 1.75-5.43), adolescents (PR: 2.297, 95% CI 1.30-4.04), adults at reproductive phase (PR: 2.127, 95% CI 1.24-3.62) and those with toothache in the last six months (PR: 1.314, 95% CI 1.08-1.59). Illiterates and individuals with up to complete elementary school were associated with lower likelihood of having full access to oral health services. Conclusion: More than half of the sample had access to oral health services, being higher in the public sector than in the private sector. Having full access to oral health services was associated in the multivariate model with age, education and toothache in the last six months.

Respostas hemodinâmicas durante e após sessão de pilates em comparação com exercício aeróbico e resistido / Hemodynamic response during and after pilates session in comparison of aerobic and resistance exercise

Os objetivos foram verificar a segurança da sessão Pilates (SP) por meio do duplo produto e comparar a hipotensão (HPE) com uma sessão aeróbia (SA) e treinamento resistido (SR) em adultos jovens analisando as alterações e comportamento hemodinâmico advindo durante as sessões. 12 adultos jovens do sexo masculino (23,3 ± 2 anos; 23,9 ± 1 Kg/m²) realizaram três sessões exercícios: SA, SR e SP e uma sessão controle (SC) (60 minutos cada). A pressão arterial (PA) e a frequência cardíaca (FC) foram registradas em repouso, durante e após as sessões a cada 15 minutos durante as sessões SP, SA e SC, e a cada dois exercícios em SR. Após a sessão foram mensuradas a cada 15 minutos até 60 minutos. Os dados foram analizados pelos testes ANOVA One-way (intragrupo) com Post Hoc de Bonferroni e ANOVA Two-way (intergrupo) com post hoc de Newman-Keuls. O duplo produto foi calculado (FC x PAS). Os resultados das sessões de exercício elevaram significativamente o duplo-produto com valores médios próximos a 25,000±1670, 16,000±3400 e 14,000±1420 mmHg.bpm respectivamente para SA, SR e SP. Refletiram em HPE sistólica significativas aos 15, 30, 45 e 60 minutos em SA. Aos 45 e 60 minutos em SR, e SP não produziu reduções significativas apresentando reduções dos componentes sistólicos de 4±4 a 6±3 mmHg. Nenhuma sessão produziu alteração HPE diastólica. SP com menores magnitudes apresentou valores médios entre 2 ± 4 a 4 ± 2 mmHg. Entretanto as HPEs não apresentaram diferenças significativas entre as mesmas. Conclui-se que SP apresenta comportamento hemodinâmico seguro em adultos jovens por permanecer abaixo da faixa máxima estabelecida (≤30.000mmHg). Apesar de não observar resultados significativos na HPE, apresenta comportamento hemodinâmico semelhante a SA e SR.

The objectives were to verify the safety of the Pilates Session (SP) through the double product and to compare the hypotension (PEH) with an aerobic (SA) and resistance (RS) session in young adults by analyzing the changes and hemodynamic behavior during sessions. 12 young male adults (23.3 ± 2 years; 23.9 ± 1 kg / m²) performed three exercise sessions: SA, RS and SP and control session (SC) (60 minutes each). Blood pressure (BP) and heart rate (HR) were recorded at rest, during and after the sessions every 15 minutes during the SP, SA and SC sessions and every two exercises in RS. After the session measured by every 15 minutes until 60 minutes. The data were analyze by One-Way ANOVA with Bonferroni's post hoc test (intragroup) and Two-Way ANOVA (intergroup) with Newman-Keuls's post hoc test. The double product was calculated (HR x SBP). The results shows the exercise sessions significantly increased the double-product with an average of values near the 25,000±1670, 16,000±3400 e 14,000±1420 mmHg.bpm respectively for SA, RS and SP. Reflected in significant difference at 15, 30, 45 and 60 minutes in SA systolic PEH. At 45 and 60 minutes in RS and SP did not produced, showing reductions of systolic components 4±4 a 6±3 mmHg. The sessions produced no statistical changes in diastolic HPE. SP with smaller magnitudes showed with average values between 2±4 a 4±2mmHg. However the HPE's were not statistical different between them. Therefore, SP is safe hemodynamically in young adults to remain below the maximum established range (≤30.000mmHg). Although were not observed significant results in HPE, shows a similar hemodynamic behavior in comparison to SA and RS.