The relationship between oral health-related quality of life, the need for orthodontic treatment and bullying, among Brazilian teenagers

ABSTRACT Introduction: Orthodontic treatment aims at oral health and restoration of function as main objectives, however, psychological and social effects end up being the main reason for the demand for treatment. Objective: To determine the association between the oral health-related quality of life (OHRQoL), the need for orthodontic treatment and bullying among Brazilian teenagers. Methods: This was a cross-sectional epidemiological study. To assess the malocclusion, the Dental Aesthetic Index was used. And the Oral Health Impact Profile-14 was used to analyze the OHRQoL. The Kidscape questionnaire was used to investigate cases of bullying. The following variables were also included: previous orthodontic treatment and a desire to fix the teeth to improve one's appearance. Multivariate analysis was performed using logistic regression considering the poor OHRQoL as a response variable. Results: 815 teenagers participated in the study. There was a statistically significant association between oral health-related quality of life and the variables: previous orthodontic treatment (p= 0.0270), desire to fix the teeth (p< 0.0001), sex (p= 0.0309), history of being a victim of bullying (p< 0.0001), frequency of bullying episodes (p= 0.0170), and consequences of bullying (p< 0.0001). The following were considered as risk factors for poor OHRQoL: lack of previous orthodontic treatment (OR = 2.191) and negative consequences of bullying (OR = 3.042). Conclusion: The need for orthodontic treatment was not associated with the OHRQoL; however, bullying and previous orthodontic treatment had a statistically significant association with this variable.

RESUMO Introdução: o tratamento ortodôntico visa à saúde bucal e ao reestabelecimento da função como objetivo final; no entanto, os efeitos psicológicos e sociais acabam sendo o principal motivo da procura pelo tratamento. Objetivo: determinar a associação entre a qualidade de vida relacionada à saúde bucal (QVRSB), a necessidade de tratamento ortodôntico e o bullying entre os adolescentes. Métodos: trata-se de um estudo epidemiológico transversal. Para avaliar a má oclusão, foi utilizado o Dental Aesthetic Index. O instrumento Oral Health Impact Profile-14 foi utilizado para analisar a QVRSB. O questionário Kidscape foi utilizado para verificar os casos de bullying. Também foram incluídas as variáveis: tratamento ortodôntico prévio e desejo de corrigir os dentes para melhorar a aparência. A análise multivariada foi realizada por meio de regressão logística, considerando-se a qualidade de vida ruim como variável resposta. Resultados: 815 adolescentes participaram da pesquisa. Houve associação, estatisticamente significativa, entre a qualidade de vida relacionada à saúde bucal e as variáveis: tratamento ortodôntico prévio (p= 0,0270), desejo de corrigir os dentes (p< 0,0001), sexo (p= 0,0309), bullying (p< 0,0001), frequência de episódios de bullying (p= 0,0170) e consequências do bullying (p< 0,0001). Foram considerados como fatores de risco para uma QVRSB ruim os adolescentes que não realizaram tratamento ortodôntico prévio a esse estudo (OR= 2,191) e aqueles que revelaram consequências negativas relacionadas aos episódios de bullying (OR= 3,042). Conclusão: a necessidade de tratamento ortodôntico não foi associada à qualidade de vida relacionada à saúde bucal, já o bullying e o tratamento ortodôntico prévio tiveram associação estatisticamente significativa com essa variável.

Treatment adherence in patients living with HIV/AIDS assisted at a specialized facility in Brazil

Abstract INTRODUCTION: In the 1990s, Brazil adopted a public policy that allowed for universal, free access to antiretroviral therapy (ART). Since then, treatment adherence has become a new challenge for administrators of sexually transmitted disease/acquired immunodeficiency syndrome (STD/AIDS) policies. This study quantified adherence to ART and verified whether there is an association between sociodemographic variables and clinical/laboratory data in human immunodeficiency virus (HIV)-infected patients. METHODS: This was a cross-sectional, exploratory study with a quantitative approach that was conducted over 8 months. The target population contained patients who were assisted at the ambulatory care facility specialized in STD/AIDS of a medium-size city located in Northwest São Paulo. In order to verify the level of adherence to ART, a validated CEAT-VIH (Assessment of Adherence to Antiretroviral Therapy Questionnaire) questionnaire was used. Sociodemographic aspects and clinical/laboratory data were obtained from the medical records. The results were analyzed using the Student's t-test and Pearson's coefficient. RESULTS Herein, 109 patients were interviewed, 56% of whom were male. The age of the population ranged 18-74 years (mean 45.67 years). Adherence to ART was classified as insufficient in 80.7% of cases. There was an association between ART adherence and presence of symptoms and/or opportunistic infection (p=0.008) and economic status (p<0.001). CONCLUSIONS: Adherence to ART among HIV carriers cared for by the public health system is low. Patients who reported a favorable economic status and those without symptoms and/or opportunistic infection demonstrated greater treatment adherence than those who needed to take more than 3 pills a day.

Self-esteem level of Brazilian teenagers victims of bullying and its relation with the need of orthodontic treatment / Nível da autoestima de adolescentes brasileiros vítimas de bullying e sua relação com a necessidade de tratamento ortodôntico

ABSTRACT Objective: The aim of this study was to analyze self-esteem among Brazilian adolescents and also verify possible associations between the variables: the need for orthodontic treatment and bullying. Methods: The cross-sectional, population-based epidemiological study consisted of a sample composed of adolescents from 11 to 16 years of age, enrolled in the public school system of a medium-sized municipality in the northwest of the State of São Paulo, Brazil. A dental examination was performed using the Dental Aesthetic Index (DAI) in order to verify the need for orthodontic treatment and a self-administered questionnaire containing the Global Self-Evaluation (GSE) indices to identify the level of self-esteem and Kidscape in order to detect bullying. Data analysis was performed using descriptive statistics, association analysis and multivariate logistic regression. Results: A total of 815 adolescents participated in the study. There was a statistically significant association between self-esteem and the variables: sex (p <.0001), willingness to straighten teeth to improve appearance (p = 0.0006), bullying victim (p <.0001), frequency of bullying = 0.0111) and consequences of bullying (p <.0001). A significant risk factor for non-white adolescents' very negative self-esteem (OR = 1.914) was present together with bullying victims who had had negative consequences after the episode (OR = 3.343). Conclusion: There was an association between the self-esteem and bullying variables. Those who reported negative consequences on bullying were three times more likely to present very negative self-esteem, and the chances of non-white adolescents to show negative self-esteem were almost twice as high. There was no statistically significant association between self-esteem and the need for orthodontic treatment.

RESUMO Objetivo: Analisar o nível da autoestima de adolescentes brasileiros e verificar as possíveis associações de desfecho com a necessidade de tratamento ortodôntico e bullying. Métodos: Estudo epidemiológico transversal de base populacional. A população foi composta por adolescentes de 11 a 16 anos, matriculados na rede pública de ensino de um município de médio porte do noroeste paulista. Foi realizado um exame bucal utilizando o índice Dental Aesthetic Index (DAI), para verificar a necessidade de tratamento ortodôntico, e um questionário autoaplicável, contendo os índices Global Self-Evaluation (GES), para identificar o nível de autoestima, e o Kidscape, para detecção de bullying. A análise dos dados foi feita utilizando estatística descritiva, análises de associação e regressão logística multivariada. Resultados: No total, 815 adolescentes participaram da pesquisa. Houve associação estatisticamente significante entre autoestima e as variáveis: sexo (p<.0001), vontade de corrigir os dentes para melhorar a aparência (p=0.0006), vítima de bullying (p<.0001), frequência com que sofreu bullying (p=0.0111) e consequências do bullying (p<.0001). Apresentaram-se como fator de risco significante para uma autoestima muito negativa a cor da pele não branca (OR=1.914) e vítimas de bullying que tiveram consequências negativas após o episódio (OR= 3.343). Conclusão: Houve associação entre as variáveis autoestima e bullying. Aqueles que relataram consequências negativas sobre o bullying apresentaram chances três vezes maiores de ter autoestima muito negativa, já as chances dos adolescentes com cor da pele não branca foram quase duas vezes maiores. Não houve associação estatisticamente significante entre autoestima e necessidade de tratamento ortodôntico.

Um Estudo Transversal Sobre Cinco Anos de Denúncia Sobre Violência Contra Crianças e Adolescentes em Araçatuba - São Paulo / A Cross-Sectional Study of Five Years of Reporting on Violence Against Children and Adolescents in Araçatuba - São Paulo

A violência contra crianças e adolescentes, por vezes, é entendida como uma forma de disciplina e não como agressão. Portanto, delinear o perfil de vítimas e agressores é importante para que se possa visualizar, conhecer e enfrentar esse problema. Este estudo objetivou verificar a ocorrência de maus-tratos contra crianças e adolescentes e suas características. Trata-se de estudo transversal, descritivo, de análise documental. Foram investigados os registros policiais (n=1506) de uma delegacia especializada, em um município de médio porte, no período de 2008 a 2012, e analisados os dados relativos ao perfil sóciodemográfico das vítimas e dos agressores, e à agressão: tipo; local; motivo; presença de álcool e drogas durante a agressão e relação vítima-agressor. Do total, a maioria das vítimas era do sexo feminino (67,9%), brancas (64,74%), com idade entre 11-15 anos (40,58%); os agressores eram homens (62,42%), brancos (46,75%), faixa etária 10-20 anos (18,20%). A violência física foi prevalente (57,0%), ocorrida na própria residência (60,03%) e as mães foram as principais agressoras (37,29%). A discussão e/ou desentendimento foram o maior motivo (39,91%) para justificar as agressões. Conclui-se que houve um aumento das ocorrências registradas contra crianças e adolescentes durante os cinco anos de estudo, prevalecendo a violência física contra meninas, sendo as mães a principal personagem desses atos.(AU)

Violence against children and adolescents, sometimes is understood as a form of discipline rather than aggression. Therefore, outlining the victims and offenders' profile is important so that it is possible to see, know and experience this problem. This study aimed to verify the occurrence of maltreatment withchildren and adolescents and their characteristics. It is cross-sectional, descriptive and documentary analysis. Police reports were investigated (n=1506) from a specialized police station, in a medium-sized municipality, from 2008 to 2012, and analyzed the data on the socio-demographic profile of the victims and perpetrators, and aggression: type; local; reason; the presence of alcohol and drugs during the assault and victim-offender relationship. Out of the total, most of the victims were female (67.9%), white (64.74%), aged 11- 15 years (40.58%); the attackers were men (62.42%), white (46.75%), aged 10-20 years (18.20%). Physical violence was prevalent (57.0%), which took place in their own residence (60.03%) and mothers were the main aggressors (37.29%). Quarreling and / or disagreement were the most prevalent reason (39.91%) to justify the aggression. It was concluded that there was an increase in incidents recorded against children during the 5 years of study, prevailing physical violence against girls, beingthe mothers the main character of such acts.(AU)

Bullying e má oclusão relacionados a autoestima e qualidade de vida em adolescentes / The relation between bullying, malocclusion, self-esteem and quality of life in teenagers

A adolescência representa um período de grandes transformações, os conceitos e a formação de caráter desenvolvidos nessa fase perpetuam ao longo da vida. A imagem corporal, muitas vezes é superestimada pelos jovens. Desvios do padrão estético de beleza, como a má oclusão, podem afetar negativamente o convívio social. O bullying, em idade escolar é cada vez mais reconhecido como um problema importante que afeta o bem-estar e o funcionamento social. Objetivou-se verificar a associação de bullying e necessidade de tratamento ortodôntico com nível de autoestima e qualidade de vida relacionada a saúde bucal em adolescentes brasileiros matriculados na rede pública de ensino. Trata-se de um estudo epidemiológico transversal de base populacional. A população foi composta por adolescentes de 11 a 16 anos, matriculados na rede pública de ensino de um município de médio porte do noroeste paulista. Para avaliar a necessidade de tratamento ortodôntico foi utilizado o índice Dental Aesthetic Index (DAI). As demais variáveis foram coletadas por meio de um questionário autoaplicável, contendo informações sobre tratamento ortodôntico prévio, desejo de corrigir o dente para melhorar a aparência, a escala Global Negative Self-Evaluation (GES) e o índice Oral Health Profile -14 (OHIP-14). Para avaliação do bullying foi utilizado o questionário Kisdcape. A análise dos dados foi feita utilizando estatística descritiva, análises de associação e regressão logística multivariada. No total, 815 adolescentes participaram da pesquisa. Houve associação estatisticamente significante entre a autoestima e as variáveis: sexo (p<.0001), vontade de corrigir os dentes para melhorar a aparência (p=0.0006), vítima de bullying (p<.0001), frequência com que sofreu bullying (p=0.0111) e consequências do bullying (p<.0001). Apresentaram-se como fator de risco para qualidade de vida ruim, aqueles que não realizaram tratamento ortodôntico prévio (OR= 2.191) e vítimas de bullying com consequências...

The adolescence is the period of life when all big transformations occur; concepts and character formation developed in this period last for the rest of a person’s life. Because body image is often super estimated by teenagers, deviation from beauty standards and ideals, such as the malocclusion, may negatively affect the social interactions. Bullying in school ages is recognized as an important problem that affects welfare and social interactions. Based on this context, this study’s goal was to verify the association of the need for orthodontic treatment and bullying with the level of self-esteem and the oral health-related quality of life of Brazilian teenagers enrolled in public schools. This is a population-based, cross-sectional epidemiological study. The population is comprised from 11 to 16 year-old teenagers, enrolled in public schools from a medium-sized city of the northwest region of the state of São Paulo, Brazil. Dental Aesthetic Index (DAI) was used to verify the need for orthodontic treatment. Other variables were collect through the use of a self-reporting questionnaire, containing information on previous orthodontic treatment, desire to correct the tooth to improve appearance, the Oral Health Impact Profile-14 (OHIP-14) and Gloval Negative Self-Evaluation (GES) scales. Kidscape questionnaire was used to assess bullying. Descriptive statistics, association analysis and multivariable logistic regression were used for data analysis. Totally, 815 teenagers participated of the study. The variable self-esteem had a statistically significant association with gender (p<.0001), the desire to correct the tooth to improve appearance (p=0.0006), the fact of being a bullying victim (p<.0001), the frequency with which the teenager suffered bullying (p=0.0111) and the effects of bullying (p<.0001). The factors nonwhite teenagers (OR=1.914) and bullying victims that experienced negative effects after bullying (OR= 3.343) were significant for a quite low...

Bullying e má oclusão relacionados a autoestima e qualidade de vida em adolescentes / The relation between bullying, malocclusion, self-esteem and quality of life in teenagers

A adolescência representa um período de grandes transformações, os conceitos e a formação de caráter desenvolvidos nessa fase perpetuam ao longo da vida. A imagem corporal, muitas vezes é superestimada pelos jovens. Desvios do padrão estético de beleza, como a má oclusão, podem afetar negativamente o convívio social. O bullying, em idade escolar é cada vez mais reconhecido como um problema importante que afeta o bem-estar e o funcionamento social. Objetivou-se verificar a associação de bullying e necessidade de tratamento ortodôntico com nível de autoestima e qualidade de vida relacionada a saúde bucal em adolescentes brasileiros matriculados na rede pública de ensino. Trata-se de um estudo epidemiológico transversal de base populacional. A população foi composta por adolescentes de 11 a 16 anos, matriculados na rede pública de ensino de um município de médio porte do noroeste paulista. Para avaliar a necessidade de tratamento ortodôntico foi utilizado o índice Dental Aesthetic Index (DAI). As demais variáveis foram coletadas por meio de um questionário autoaplicável, contendo informações sobre tratamento ortodôntico prévio, desejo de corrigir o dente para melhorar a aparência, a escala Global Negative Self-Evaluation (GES) e o índice Oral Health Profile -14 (OHIP-14). Para avaliação do bullying foi utilizado o questionário Kisdcape. A análise dos dados foi feita utilizando estatística descritiva, análises de associação e regressão logística multivariada. No total, 815 adolescentes participaram da pesquisa. Houve associação estatisticamente significante entre a autoestima e as variáveis: sexo (p<.0001), vontade de corrigir os dentes para melhorar a aparência (p=0.0006), vítima de bullying (p<.0001), frequência com que sofreu bullying (p=0.0111) e consequências do bullying (p<.0001). Apresentaram-se como fator de risco para qualidade de vida ruim, aqueles que não realizaram tratamento ortodôntico prévio (OR= 2.191) e vítimas de bullying com consequências...

The adolescence is the period of life when all big transformations occur; concepts and character formation developed in this period last for the rest of a person’s life. Because body image is often super estimated by teenagers, deviation from beauty standards and ideals, such as the malocclusion, may negatively affect the social interactions. Bullying in school ages is recognized as an important problem that affects welfare and social interactions. Based on this context, this study’s goal was to verify the association of the need for orthodontic treatment and bullying with the level of self-esteem and the oral health-related quality of life of Brazilian teenagers enrolled in public schools. This is a population-based, cross-sectional epidemiological study. The population is comprised from 11 to 16 year-old teenagers, enrolled in public schools from a medium-sized city of the northwest region of the state of São Paulo, Brazil. Dental Aesthetic Index (DAI) was used to verify the need for orthodontic treatment. Other variables were collect through the use of a self-reporting questionnaire, containing information on previous orthodontic treatment, desire to correct the tooth to improve appearance, the Oral Health Impact Profile-14 (OHIP-14) and Gloval Negative Self-Evaluation (GES) scales. Kidscape questionnaire was used to assess bullying. Descriptive statistics, association analysis and multivariable logistic regression were used for data analysis. Totally, 815 teenagers participated of the study. The variable self-esteem had a statistically significant association with gender (p<.0001), the desire to correct the tooth to improve appearance (p=0.0006), the fact of being a bullying victim (p<.0001), the frequency with which the teenager suffered bullying (p=0.0111) and the effects of bullying (p<.0001). The factors nonwhite teenagers (OR=1.914) and bullying victims that experienced negative effects after bullying (OR= 3.343) were significant for a quite low...