Orthodontics in the oral health care network of the Unified Health System (SUS).

This observational study aimed to describe and analyze data from two external evaluations of the National Program for Improving Access to and Quality of Dental Specialty Centers (PMAQ CEO), held in 2014 and 2018 in Brazil, which evaluated Dental Specialty Centers (CEO) using a national and census approach. We selected questions through a search in the microdata of the first and second evaluations. The groups were analyzed independently. To compare the groups, nonparametric tests were performed (Mann Whitney U). The formulated hypotheses were: there would be no differences between the data of these groups (h0) and there would be differences between the data of these groups (h1). For qualitative nominal variables, frequency distribution was verified and association tests were performed (chi-square test). The significance level for this study was set at 5%. We observed that orthodontic treatments were found in about 13% of the CEO. Regarding human resources, most professionals were specialists or had MSc or PhD degrees; were civil servants; had been hired by direct administration; or had been hired via public tender. Regarding the work process and inclusion of the CEO in the health care network, we observed a greater number of services that use single and electronic medical records, greater presence of services monitoring and analyzing goals, greater knowledge about monthly average of absenteeism (for 2018); and larger number of services with referrals from primary health care centers (for 2014). Expanding the view on orthodontics and including preventive, interceptive, and corrective treatments at different points in health care networks are essential strategies for achieving comprehensive care in universal health systems.

Orthodontics in the oral health care network of the Unified Health System (SUS)

Abstract This observational study aimed to describe and analyze data from two external evaluations of the National Program for Improving Access to and Quality of Dental Specialty Centers (PMAQ CEO), held in 2014 and 2018 in Brazil, which evaluated Dental Specialty Centers (CEO) using a national and census approach. We selected questions through a search in the microdata of the first and second evaluations. The groups were analyzed independently. To compare the groups, nonparametric tests were performed (Mann Whitney U). The formulated hypotheses were: there would be no differences between the data of these groups (h0) and there would be differences between the data of these groups (h1). For qualitative nominal variables, frequency distribution was verified and association tests were performed (chi-square test). The significance level for this study was set at 5%. We observed that orthodontic treatments were found in about 13% of the CEO. Regarding human resources, most professionals were specialists or had MSc or PhD degrees; were civil servants; had been hired by direct administration; or had been hired via public tender. Regarding the work process and inclusion of the CEO in the health care network, we observed a greater number of services that use single and electronic medical records, greater presence of services monitoring and analyzing goals, greater knowledge about monthly average of absenteeism (for 2018); and larger number of services with referrals from primary health care centers (for 2014). Expanding the view on orthodontics and including preventive, interceptive, and corrective treatments at different points in health care networks are essential strategies for achieving comprehensive care in universal health systems.

A systematic review of the measurement properties of self-report screening tools to detect risk or exposure to child sexual abuse for children under 12.

Child sexual abuse (CSA) is a substantial public health issue that is challenging to measure epidemiologically due to the "pact of silence" among those involved. Validated tools could contribute to early recognition or risk detection for CSA. We aimed to systematically assess self-report tools' measurement properties and methodological quality that detect risk or exposure to CSA for children under twelve. The search strategy, selection criteria, data extraction, data analysis, and synthesis followed the COSMIN methodology for systematic reviews (2018). PROSPERO 2021 registration CRD42021278465. MEDLINE, COCHRANE, EMBASE, CINAHL, SCOPUS, and ERIC were searched until August 2021, with an updated search on September 23, 2021, and unlimited by language. The inclusion criteria were: to assess risk or exposure to CSA under twelve years old by objective items and self-report tools; sexual violence risk or exposure in the domestic context; the application context should include health facilities (such as hospital emergency rooms, outpatient clinics, pediatric wards, psychology centers, social services), education (such as schools) and community; no language or date restriction. The exclusion criteria were: non-self-report tools studies, comprehensive articles, comments, editorials, expert opinions, and studies of projective techniques. The COSMIN risk of bias checklist was used to evaluate the methodological quality of the included studies. Feasibility aspects were assessed. This study had no funding source; 29 studies describing eight tools met eligibility criteria. No single instrument reported all nine measurement properties outlined by the COSMIN methodology. The strength of the evidence was moderate to high for six out of eight instruments. ICAST-C and JVQ were the tools that obtained the highest number of rated measurement properties and strength of evidence.

Assessment of responsiveness and minimum important difference of the Maternal perception of Childbirth Fatigue Questionnaire (MCFQ) / Avaliação da responsividade e diferença mínima importante do Questionário de percepção Materna de Fadiga no trabalho de Parto (QMFP)

INTRODUCTION: The assessment of responsiveness and the Minimum Clinically Important Difference (MCID) is the basis for validating the Maternal perception of Childbirth Fatigue Questionnaire (MCFQ). OBJECTIVE: To assess the responsiveness and determine the value of the MCID for the MCFQ. METHODS: This is an observational study, conducted at HC-UFPE with 50 parturients in active labor. The MCFQ was applied in two moments: in the initial evaluation (EV1), performed at the beginning of labor between 4-6 cm of uterine dilation, and final (EV2), six hours after the first evaluation. Responsiveness was determined by calculating the effect size (ES), and standardized response mean (SRM), considering that values of 0.2, 0.5, and 0.8 points represent respectively small, moderate, or large values of responsiveness. The ability to detect change through the questionnaire was also assessed by the t-test. The level of significance adopted for this analysis was p less than 0.05. The MCID was verified based on the calculation of the standard error of measurement (SEM) index. RESULTS: The MCFQ showed values of 0.4 and 0.6 for ES and SEM respectively and a p-value <0.001, thus showing a good capacity for change. The value of the MCID for this population was seven points. CONCLUSION: MCFQ presents a potentially significant change with a value of the MCID of seven points after six hours of active labor.

INTRODUÇÃO: A avaliação da responsividade e da Diferença Mínima Importante (DMI) é fundamentação para validação do Questionário de percepção Materna de Fadiga no Trabalho de Parto (QMFP). OBJETIVO: Avaliar a responsividade e determinar o valor da DMI para o QMFP. MÉTODOS: Trata-se de um estudo observacional, realizado no HC-UFPE com 50 parturientes em fase ativa do trabalho de parto. O QMFP foi aplicado em dois momentos: na avaliação inicial (AV1), realizada no início do trabalho de parto entre 4-6 centímetro de dilatação uterina, e final (AV2), após seis horas da primeira avaliação. A responsividade foi determinada pelo cálculo do effect size (ES), standardized response mean (SRM), considerando que valores de 0,2, 0,5 e 0,8 pontos representam respectivamente um pequeno, moderado ou grande valor de responsividade. A capacidade de detectar mudança pelo questionário também foi avaliada pelo test t. O nível de significância adotado para essa análise foi p menor que 0,05. A DMI foi verificada com base no cálculo do índice standard error of measurement (SEM). RESULTADOS: O QMFP apresentou valores de 0,4 e 0,6 de ES e SEM respectivamente e valor de p<0,001, logo apresenta uma boa capacidade de mudança. O valor da DMI para esta população foi de sete pontos. CONCLUSÃO: O QMFP apresenta uma mudança potencialmente significativa com um valor da DMI de sete pontos após seis horas de trabalho de parto ativo.

Economic Impact of the COVID-19 Pandemic among Dentists in One of the Poorest Brazilian States: A Cross-Sectional Study

ABSTRACT Objective: To analyze the impact of the COVID-19 pandemic on dentists' income and to identify associated factors in one of the poorest Brazilian states. Material and Methods: A cross-sectional study including dentists who volunteered to answer an electronic questionnaire in Maranhão. Hierarchical multinomial logistic regression analyses were performed, estimating crude and adjusted odds ratios (OR) and respective 95% confidence intervals (95%CI) (alpha=5%). Results: The COVID-19 pandemic impacted the professionals´ income negatively [55.44% (50.26-60.52%)] and also positively [6.9% (4.55-9.94%)]. The negative impact on income was greater among male dentists (OR=2.54; 95%CI: 1.16-5.53), over 30 years of age (OR=3.03; 95%CI: 1.34-6.87), with family income below two minimum wages (OR=4.63; 95%CI: 1.50-14.30), who worked in the continent instead of in the capital island (OR=2.21; 95%CI: 1.14-4.29) and in the private sector (OR=31.43; 95%CI: 11.59-85.22). Moreover, those who had been tested for COVID-19, with a negative result, had a 21.3-fold greater chance of having an increased household income when compared to those who had not been tested. Conclusion: The COVID-19 pandemic negatively impacted the dentists' income in Maranhão, especially the older, males, with lower incomes, and who worked in the private sector, living far from the capital. The SUS played an important role in the social protection of dentists during the COVID-19 pandemic, mitigating the economic impacts on the public sector working class.

Escala de empoderamento juvenil pela educação em saúde: estudo de validação / Escala de empoderamiento juvenil por la educación para la salud: estudio de validación / Youth empowerment through health education scale: validity study

Resumo Objetivo Validar o conteúdo e a aparência da Escala de Empoderamento Juvenil pela Educação em Saúde (EJEduS) após uma intervenção educativa. Métodos Estudo metodológico realizado mediante a avaliação da Escala de Empoderamento Juvenil pela Educação em Saúde (EJEduS) pelos critérios de relevância, clareza e pertinência, por especialistas na temática como também por adolescentes escolares e de uma comunidade quilombola. A análise deu-se pelo Índice e pelo Coeficiente de Validade de Conteúdo, além do cálculo de Gwet AC2, para verificar a concordância inter e intraespecialistas. Resultados Dos 50 itens iniciais da escala, observou-se a necessidade de reformulação de 18 deles e a exclusão de 11 após discussão de consenso com os adolescentes. A concordância intraespecialistas se mostrou quase perfeita para os três critérios: relevância (Gwet: 0,894; IC95% 0,825-0,919), clareza (Gwet: 0,848; IC95% 0,816-0,879) e pertinência (Gwet: 0,896; IC95% 0,870-0,923). Na análise de concordância intra-adolescentes, observou concordância quase perfeita (Gwet: 0,96; IC95% 0,917-1), e com taxas de Índice e Coeficiente de Validade de Conteúdo aceitáveis de concordância, ambos com 0,91. Conclusão A escala apresentou Índices de Validade de Conteúdo e aparência satisfatórios para aferir o empoderamento juvenil pela educação em saúde.

Resumen Objetivo Validar el contenido y la apariencia de la Escala de Empoderamiento Juvenil por la Educación para la Salud (EJEduS) después de una intervención educativa. Métodos Estudio metodológico realizado mediante la evaluación de la Escala de Empoderamiento Juvenil por la Educación para la Salud (EJEduS), según criterios de relevancia, claridad y pertinencia, tanto por especialistas del tema, como también por adolescentes escolares y de una comunidad quilombola. El análisis se realizó a través del Índice y del Coeficiente de Validez de Contenido, además del cálculo de Gwet AC2, para verificar la concordancia inter e intraespecialistas. Resultados De los 50 ítems iniciales de la escala, se observó la necesidad de reformular 18 de ellos y de excluir 11 luego de una discusión de consenso entre los adolescentes. La concordancia intraespecialistas demostró ser casi perfecta en los tres criterios: relevancia (Gwet: 0,894; IC95 % 0,825-0,919), claridad (Gwet: 0,848; IC95 % 0,816-0,879) y pertinencia (Gwet: 0,896; IC95 % 0,870-0,923). En el análisis de concordancia intraadolescentes, se observó concordancia casi perfecta (Gwet: 0,96; IC95 % 0,917-1) y con valores aceptables de concordancia del Índice y Coeficiente de Validez de Contenido, ambos 0,91. Conclusión La escala presentó Índices de Validez de Contenido y apariencia satisfactorios para determinar el empoderamiento juvenil por la educación para la salud.

Abstract Objective To validate the Youth Empowerment Through Health Education Scale (EJEduS) content and appearance after an educational intervention. Methods This is a methodological study carried out through EJEduS assessment by relevance, clarity and pertinence criteria by experts in the subject as well as by school adolescents and from a quilombola community. The analysis was performed using the Content Validity Coefficient and Content Validity Index, in addition to calculating the Gwet AC2 to verify inter- and intra-expert agreement. Results Of the initial 50 items on the scale, 18 needed to be reformulated and 11 were excluded after consensus discussion with adolescents. The intra-expert agreement was almost perfect for the three criteria: relevance (Gwet: 0.894; 95%CI 0.825-0.919), clarity (Gwet: 0.848; 95%CI 0.816-0.879) and pertinence (Gwet: 0.896; 95%CI 0.870-0.923). In the intra-adolescent agreement analysis, an almost perfect agreement was observed (Gwet: 0.96; 95%CI 0.917-1), with acceptable agreement rates of Content Validity Coefficient and Content Validity Index, both with 0.91. Conclusion The scale presented satisfactory Content Validity Indexes and appearance to measure youth empowerment through health education.

Toothache and tooth extraction as reasons for dental visits: an analysis of the 2019 National Health Survey.

The aim of this study was to analyze the prevalence of dental visits due to toothache and tooth extraction in Brazil and its association with individual and contextual variables. This two-step cross-sectional study included persons aged 18 years and older in the 2019 National Health Survey who had visited a dentist in the 12 months prior to the interview (n = 40,369). The individual-level outcome was having a dental visit due to toothache or tooth extraction. The ecological-level outcome was the proportion of dental visits for these reasons relative to all dental visits by Brazilian state. Associations with individual - sociodemographic characteristics, number of teeth, and type of health service used - and ecological variables - HDI and dental service coverage - were assessed using Poisson regressions. The prevalence of dental visits due to toothache or extraction was higher among individuals with no formal education, household income < 25% of the minimum wage, of black and brown skin color, living in rural areas, who consulted in the public health system, with 10-19 and 1-9 teeth, and men. The proportion of dental visits due to toothache/extraction in Brazilian states was negatively associated with the HDI and the rate of dental emergency team/100,000 inhabitants and positively associated with primary dental care coverage. The prevalence of dental visits due to toothache/extraction was associated with individual and ecological characteristics, indicating inequities in reasons for dental visits in Brazil. The potential of a well-structured oral health care network to overcome these inequities is suggested and needs to be better explored.

Factors associated with the absence of Brazilians in specialized dental centers.

AIM: To identify the individual and contextual factors associated with the absence of Brazilians at a scheduled appointment in Dental Specialties Centers (DSC). METHODS: This cross-sectional design uses the National Program for Improving Access and Quality of Dental Specialties Centers database, 2018. The outcome was the users' lack of at least one of the scheduled appointments. Contextual and individual independent variables were used, considering Andersen's behavioural model. The analyses were performed with the R Core Team and SAS (Studio 3.8, Institute Inc, North Carolina, U.S, 2019) programs. RESULTS: Of the 10,391 patients interviewed, 27.7% missed at least one of the consultations. In the adjusted multivariate model, the interpretation based on the effect size and 95% CI showed that the behaviour individual predisposing factors such as age ≤ 42 years (OR = 1.10; 95%CI:1.01-1.21), individual need factors such as participation in the "Bolsa Família" program (OR = 1,14; 95%CI:1.02-1.27), not being covered by the Family Health Strategy (OR = 1.15; 95% CI:1.02-1.30), and users of periodontics services (OR = 1.22;95%CI:1.05-1.40) were associated with absences. The behavioural factor associated with the outcome was that the DSC facilities were not in good condition (OR = 1.18; 95%CI:1.03-1.34). DSC located in the capital (OR = 1.12; 95% CI: 0.92-1.48) were 12% more likely to have dental absences than those in the interior region. CONCLUSION: There are individual and contextual barriers associated with patients not attending specialised public dental consultations. DSC should offer adequate hours to patients, especially young adults and vulnerable people.

Contextual and local determinants associated with the achievement of goals in the endodontics specialty in Brazilian dental speciality centres: A multilevel analysis.

OBJECTIVES: To assess which factors were associated with the achievement of endodontic goals. METHODS: Cross-sectional study using secondary data from the second cycle of the Program for the Improvement of Access and Quality in the dental speciality centres-in Portuguese PMAQ-CEO. The independent variables extracted from this database were related to dental speciality centres (CEO in Portuguese). In addition, variables referring to the CEO host city were incorporated into the model. The outcome variable was the number of endodontic goals achieved calculated from the production of the CEO available in the Ambulatory Health Information System in 2018. Descriptive analyses and multilevel Poisson regression were performed with the software SPSS 23.0 and STATA 14.0. RESULTS: CEOs with more than 20% of patients' absenteeism were 26% less likely to reach the goals of the endodontics specialty; CEOs with availability of endodontists for more than 40 hours a week were two times more likely to reach the goals than those with less than 40 hours in endodontics specialty. CEOs with a waiting time for endodontic procedures greater than 45 days achieved a number of goals 31% lower than those with a waiting time up to 45 days. CEO type I and CEO type II showed 2.10 and 1.20 higher likelihood to reach the number of goals of the endodontics specialty than CEO type III. The number of endodontic instruments in sufficient number was positively associated with the achievement of goals. CEOs located in municipalities that reached more than 5% in the supervised brushing indicator had 2.26 greater likelihood to achieve the goals than those that did not reach this percentage. CONCLUSION: Contextual and local determinants are associated with the achievement of goals in the endodontic specialty in the dental speciality centres in Brazil.

Toothache and tooth extraction as reasons for dental visits: an analysis of the 2019 National Health Survey

Abstract: The aim of this study was to analyze the prevalence of dental visits due to toothache and tooth extraction in Brazil and its association with individual and contextual variables. This two-step cross-sectional study included persons aged 18 years and older in the 2019 National Health Survey who had visited a dentist in the 12 months prior to the interview (n = 40,369). The individual-level outcome was having a dental visit due to toothache or tooth extraction. The ecological-level outcome was the proportion of dental visits for these reasons relative to all dental visits by Brazilian state. Associations with individual - sociodemographic characteristics, number of teeth, and type of health service used - and ecological variables - HDI and dental service coverage - were assessed using Poisson regressions. The prevalence of dental visits due to toothache or extraction was higher among individuals with no formal education, household income < 25% of the minimum wage, of black and brown skin color, living in rural areas, who consulted in the public health system, with 10-19 and 1-9 teeth, and men. The proportion of dental visits due to toothache/extraction in Brazilian states was negatively associated with the HDI and the rate of dental emergency team/100,000 inhabitants and positively associated with primary dental care coverage. The prevalence of dental visits due to toothache/extraction was associated with individual and ecological characteristics, indicating inequities in reasons for dental visits in Brazil. The potential of a well-structured oral health care network to overcome these inequities is suggested and needs to be better explored.

Observatório de Saúde Bucal/UFPE: ações estratégicas de gestão da informação e de saúde digital em saúde bucal para melhoria da governança no SUS / Oral Health Observatory/UFPE: strategic information management and digital health actions in oral health to improve governance in SUS

O programa de extensão Observatório de Saúde Bucal (OSB/UFPE) objetiva a gestão da informação e desenvolvimento de ferramentas digitais para amelhoria da governança na saúde bucal no Sistema Único de Saúde (SUS), por meiodo desenvolvimento de pesquisa-ensino-extensão. Atualmente, abriga dois projetos: (1) Saúde Digital­desenvolvimento de ferramentas eletrônicas para avaliação de serviços e programas de saúde­e (2) Gestão da Informação em Saúde Bucal. A execução das ações tem caráter remoto, nas plataformas digitais e presenciais no Laboratório de Gestão da Informação em Saúde Bucal. Para cada projeto,visandomelhorar a qualificação dos atores envolvidos, tem havidoseminários, cursos e eventos, bem como a disponibilização de produtos técnicos e científicos: pesquisas com estudantes de graduação e pós-graduação; elaboração e divulgaçãodeboletins analíticos de serviços de saúde; desenvolvimento e uso de ferramentas de saúde digital.O OSB constituiu-secomo umarede colaborativa de trabalho com agentes múltiplosda academia(docentes, graduandos, residentes, mestrandos e mestres da área de Saúde Coletiva e Informática) e do serviço (gestores municipais e estadual, gerentes, profissionais e usuários dos serviços odontológicos do SUS),os quais se articulam sistematicamente para implementação das ações desenvolvidas conjuntamente. A operacionalização deste programa tem promovido a integraçãocom oserviço, visando à melhoria das práticas da gestãoe da atuação de profissionais nessa áreae tem contribuídoparaa tomada de decisão ágil e oportuna, pautada na evidência científica, possibilitando melhoria de qualidade e promoção de saúde (AU).

The Oral Health Observatory extension program (OSB/UFPE) aims to manage information and develop digital tools that improve the governance in oral health in the Unified Health System (SUS), through the development of research-teaching-extension. It currently shelters two projects: (1) Digital Health ­development of electronic tools for the evaluation of services and health programs ­and (2) Oral Health Information Management. The execution of these actions has a remote nature, in digital platforms and on-site at the Oral Health Information Management Laboratory. Aiming to improve the qualification of the actors involved, there has been seminars, courses, and events for each project, as well as the provision of technical and scientific products: research with undergraduate and post-graduate students; elaboration and dissemination of analytical newsletters for health services; development and use of digital health tools. The OSB is a collaborative support work network with multiple academic representatives (professors, undergraduates, residents, masters, and masters in the field of Public Health and Informatics) and services (city and state administrators, managers, professionals, and users of the dental services of the SUS), in which systematically coordinate to implement actions developed collectively. The operationalization of this program has promoted the integration with the service, aiming the improvement of management practices and the practice of professional in this field and has contributed to rapid and timely decision-making, guided on scientific evidence, enabling the improvement of the quality and promotion of health (AU).

Sociodemographic, Behavioral and Oral Health Factors in Maternal and Child Health: An Interventional and Associative Study from the Network Perspective.

Oral healthcare during pregnancy needs to be part of the assistance routine given to pregnant women by health professionals as a way to encourage self-care and strengthen the general health of the mother and the baby. The aim of this study was to evaluate the effectiveness of an integrated oral healthcare intervention for pregnant women and to analyze the association of sociodemographic, behavioral, oral health and general maternal and child health factors in prenatal care at usual risk in primary care in a city in the northeast of Brazil, in 2018-2019. A controlled, randomized, single-blinded community trial was conducted. The intervention group (IG) received dental assistance and collective health education actions in conversation circles, while the control group (CG) received the usual assistance. All pregnant women (146 in total, 58 from IG and 88 from CG) that took part in the trial answered a questionnaire and underwent a dental examination at the beginning of prenatal care and at the puerperal visit. To assess the effect of the intervention, a network analysis was used. The results have shown that being in the control group was associated with neonatal complications (0.89) and prematurity (0.54); the use of tobacco and alcohol are associated with high risk in initial and final oral health; lower educational level of the pregnant women implicates high risk for initial oral health (-0.19), final oral health (-0.26), pregnancy complications (-0.13), low birth weight (-0.23), prematurity (-0.19) and complications in the newborn (-0.14). Having a low family income (≤261.36 USD) has shown a high risk for initial oral health (-0.14), final oral health (-0.20) and prematurity (-0.15). The intervention based on integrated oral healthcare for pregnant women indicated that socioeconomic and behavioral factors must be considered as determinants for the quality of women and children's health and that multi-professional performance during prenatal care contributes to the positive outcomes of pregnancy.

Cuidados em saúde bucal a crianças e adolescentes com paralisia cerebral: percepção de pais e cuidadores / Oral health care for children and adolescents with cerebral palsy: perceptions of parents and caregivers

Resumo Objetivou-se avaliar os cuidados em saúde bucal de crianças/adolescentes com Paralisia Cerebral (PC) segundo a gravidade, através da percepção dos pais/cuidadores. Estudo série de casos realizado em serviços de saúde de Pernambuco com 94 mães/cuidadores de sujeitos com PC entre 5 e 18 anos. Avaliaram-se fatores socioeconômicos, demográficos, cuidados em saúde bucal e uso de serviços odontológicos (SO). O Sistema de Classificação da Função Motora Grossa mostrou 67% com comprometimento motor grave. Indivíduos com PC grave tiveram frequência significantemente maior de pertencerem a famílias com renda mais baixa (89%, p < 0,001), residirem no interior (44%, p < 0,005), terem dificuldades de transporte (60%, p = 0,04) e acessibilidade aos SO (88%, p = 0,009) e maior necessidade de higiene bucal (67%, p = 0,008) realizada pelas mães (94%, p < 0,001). Apesar das barreiras de acesso aos SO, o mesmo foi facilitado para aqueles com PC grave, com uso precoce dos SO, mas com baixa oferta de dentistas e de humanização. Esses resultados informam problemas relacionados aos cuidados diários em saúde bucal, contexto de vida das famílias, de apoio institucional e de qualidade dos SO a serem enfrentados com políticas públicas socioeconômicas e de saúde integrais inclusivas e equânimes.

Abstract The aim was to evaluate the oral health care of children/adolescents with Cerebral Palsy (CP) according to severity through the perceptions of parents/caregivers. A case series study was conducted at health services in the state of Pernambuco, Brazil with 94 mothers/caregivers of subjects with CP from 5 and 18 years old. Sociodemographic factors, oral health care and use of dental services (DS) were evaluated. The Gross Motor Function Classification System showed 67% with severe motor impairment. Subjects with severe CP had significantly higher frequencies of belonging to families with lower income (89%, p < 0.001), living in the interior (44%, p < 0.005), having transportation difficulties (60%, p = 0.04), difficulty regarding access to DS (88%, p = 0.009) and a greater need for oral hygiene (67%, p = 0.008), which was performed exclusively by the caregiver (94%, p < 0.001). Despite identified access barriers, dental care was facilitated for those with severe CP, early DS use, but low availability of dentists and low degree of humanization were cited as major problems. These results reveal problems related to daily oral health care, family living context, institutional support and quality of DS that should be addressed in comprehensive, inclusive, equitable social and economic public policies.

Factors associated with conducting planning for secondary oral health care services in Brazil.

BACKGROUND: Planning in health services specifically aims to improve the health status of a given population, guaranteeing access with equity and justice, as well as streamlining the response of the health system to the needs perceived by the community. This research aims to identify the factors associated with planning Specialized Dental Clinics (SDCs). METHODS: Secondary data were used from the external evaluation of the database of the first National Program for Access and Quality Improvement of SDCs (NPAQI-SDCs) and the informed Outpatient Information System of the Unified Health System (OIS/UHS), which contains data on the specialized dental procedures performed at SDCs. It consisted of a quantitative study in which Pearson chi-square statistical tests (p < 0.05) and a multivariate logistic regression were applied with odds ratio (OR) estimate. RESULTS: The results indicated that the realization of planning in SDCs was associated with lower coverage of the Oral Health Team of the Familiy Health Strategy in a municipality (OR = 1.4; 95% CI: 1.0-1.9, p = 0.049), additional training for managers (p = 0.038), the practice of self-assessment (OR = 8.2; 95% CI: 5.8-11.6; p = 0.000) and meeting service production targets (OR = 1.9; 95% CI: 1.2-3.2; p = 0.011). CONCLUSION: The results indicate that the work processes of the SDCs, especially with regard to service management, are essential to the proper functioning of the service and the practice of planning is linked to the technical capacity and commitment of service managers.

Oral health care for children and adolescents with cerebral palsy: perceptions of parents and caregivers. / Cuidados em saúde bucal a crianças e adolescentes com paralisia cerebral: percepção de pais e cuidadores.

The aim was to evaluate the oral health care of children/adolescents with Cerebral Palsy (CP) according to severity through the perceptions of parents/caregivers. A case series study was conducted at health services in the state of Pernambuco, Brazil with 94 mothers/caregivers of subjects with CP from 5 and 18 years old. Sociodemographic factors, oral health care and use of dental services (DS) were evaluated. The Gross Motor Function Classification System showed 67% with severe motor impairment. Subjects with severe CP had significantly higher frequencies of belonging to families with lower income (89%, p < 0.001), living in the interior (44%, p < 0.005), having transportation difficulties (60%, p = 0.04), difficulty regarding access to DS (88%, p = 0.009) and a greater need for oral hygiene (67%, p = 0.008), which was performed exclusively by the caregiver (94%, p < 0.001). Despite identified access barriers, dental care was facilitated for those with severe CP, early DS use, but low availability of dentists and low degree of humanization were cited as major problems. These results reveal problems related to daily oral health care, family living context, institutional support and quality of DS that should be addressed in comprehensive, inclusive, equitable social and economic public policies.

Objetivou-se avaliar os cuidados em saúde bucal de crianças/adolescentes com Paralisia Cerebral (PC) segundo a gravidade, através da percepção dos pais/cuidadores. Estudo série de casos realizado em serviços de saúde de Pernambuco com 94 mães/cuidadores de sujeitos com PC entre 5 e 18 anos. Avaliaram-se fatores socioeconômicos, demográficos, cuidados em saúde bucal e uso de serviços odontológicos (SO). O Sistema de Classificação da Função Motora Grossa mostrou 67% com comprometimento motor grave. Indivíduos com PC grave tiveram frequência significantemente maior de pertencerem a famílias com renda mais baixa (89%, p < 0,001), residirem no interior (44%, p < 0,005), terem dificuldades de transporte (60%, p = 0,04) e acessibilidade aos SO (88%, p = 0,009) e maior necessidade de higiene bucal (67%, p = 0,008) realizada pelas mães (94%, p < 0,001). Apesar das barreiras de acesso aos SO, o mesmo foi facilitado para aqueles com PC grave, com uso precoce dos SO, mas com baixa oferta de dentistas e de humanização. Esses resultados informam problemas relacionados aos cuidados diários em saúde bucal, contexto de vida das famílias, de apoio institucional e de qualidade dos SO a serem enfrentados com políticas públicas socioeconômicas e de saúde integrais inclusivas e equânimes.

Specialized dental care for people with disabilities in Brazil: profile of the Dental Specialty Centers, 2014. / Atenção odontológica especializada para pessoas com deficiência no Brasil: perfil dos centros de especialidades odontológicas, 2014.

OBJECTIVE: To describe the oral health care services for people with disabilities treated within the Dentistry for Patients with Special Needs (PSN) specialty. METHODS: This was a cross-sectional study with data from the Program for Improving Access and Quality of Dental Specialty Centers (PMAQ-CEO) in 2014. RESULTS: Of the total of 932 services evaluated, 89.8% did provide care for PSNs, 30.4% had physical accessibility, 59.7% provided referral to hospital care and most guaranteed complete treatment. Only a third of the Dental Specialty Centers planned 40 or more hours a week for providing clinical care to PSNs. CONCLUSION: The care network for people with disabilities is being formed but, even with specific financial incentives, it has limitations. Services need to eliminate physical and attitudinal barriers to ensure universal accessibility. Protocols based on risk classification are necessary, prioritizing care at DSCs for complex cases not attended to in Primary Care and organizing the dental health care network for people with disabilities.

Specialized dental care for people with disabilities in Brazil: profile of specialized dental clinics, 2014 / Atención odontológica especializada para personas con discapacidad en Brasil: perfil de los centros de especialidades odontológicas, 2014 / Atenção odontológica especializada para pessoas com deficiência no Brasil: perfil dos centros de especialidades odontológicas, 2014

Objective. To analyze the specialized services of oral health care for people with disabilities, attended by the specialty of Special Care Dentistry (SCD). Methods. A cross-sectional study with data from the Program for Improving Access and Quality of Dental Specialties Centers (PMAQ-CEO), 2014. Results. A total of 932 services were evaluated: 89.8% did have SCD, 30.4% had physical accessibility, 59.7% had reference to hospital care and most guaranteed complete treatment. Only a third of the CEOs offered 40 hours per week of SCD. Conclusion. The network of care for people with disabilities is being formed, and even with specific financial incentives, has limitations. Services need to eliminate physical and attitudinal barriers to ensure universal accessibility. Protocols based on risk classification are necessary, prioritizing the attendance in the CEO of the complex cases, not attended in the primary care and organizing the dental health care network of the people with disabilities.

Objetivo. Descrever os serviços de atenção à saúde bucal para pessoas com deficiência, atendidas pela especialidade Odontologia para Pacientes com Necessidades Especiais (PNE). Métodos. Estudo transversal, com dados do Programa de Melhoria do Acesso e Qualidade dos Centros de Especialidades Odontológicas (PMAQ-CEO), 2014. Resultados. Dos 932 serviços avaliados, 89,8% contavam com atendimento a PNEs, 30,4% apresentavam acessibilidade física e 59,7% contavam com referência para atendimento hospitalar. A maioria garantia tratamento completo. São disponibilizadas 40h semanais de atendimento clínico a PNEs em 1/3 dos CEOs. Conclusão. A rede de cuidado para pessoas com deficiência encontra-se em formação e, apesar dos incentivos financeiros específicos, apresenta limitações. Os serviços precisam eliminar barreiras físicas e atitudinais para garantir acessibilidade universal. Protocolos baseados em classificação de risco são necessários, priorizando atendimento no CEO dos casos complexos, não atendidos na Atenção Básica e organizando a rede de cuidados em saúde bucal da pessoa com deficiência.

Characterization of dental surgeons of Pernambuco in the COVID-19 pandemic context: preliminary data.

This study aimed to present preliminary research results about the impact of COVID-19 on the professional practice of dentists in Pernambuco. This is a cross-sectional, descriptive, and exploratory study, whose population was composed of dental surgeons with active enrollment in the Regional Dentistry Council of Pernambuco. Data collection was performed using an electronic form and included characterization of professionals (gender, age, time since graduation, marital status, family income and field of work) and health status (vaccination schedule, presence of comorbidities, biosafety knowledge and testing for COVID-19). Preliminary data correspond to the first week of collection, which were analyzed from the frequency, proportions, and measures of central tendency distributions. Of the 363 dental surgeons, for the field of work, 38.6% work in both the public and private sectors. Comorbidities related to the worsening of COVID-19 were identified in 35.0% of participants, 24.5% are not up to date with influenza and hepatitis vaccines, and 79.3% have not been tested for COVID-19. Regarding the biosafety instructions for COVID-19, 30.7% received no training. It is necessary to immunize dental surgeons to prevent from immunilogical diseases and expansion of the testing capacity for COVID-19, especially for professionals belonging to the risk group. In addition to guaranteeing the offer of qualification courses on biosafety, which is essential for the safe resumption of activities.

Este estudo objetivou apresentar resultados preliminares de pesquisa acerca do impacto da COVID-19 na prática profissional de cirurgiões-dentistas de Pernambuco. Trata-se de um estudo transversal, descritivo e exploratório, cuja população foi composta por cirurgiões-dentistas com inscrição ativa no Conselho Regional de Odontologia de Pernambuco. A coleta de dados foi realizada por meio de formulário eletrônico e contemplou caracterização dos profissionais (sexo, idade, tempo de formado, estado civil, renda familiar e setor de atuação) e situação de saúde (esquema vacinal, presença de comorbidades, conhecimento sobre biossegurança e realização de teste para COVID-19). Os dados preliminares correspondem a primeira semana de coleta, os quais foram analisados a partir da distribuição de frequência, proporções e medida de tendência central. Dos 363 cirurgiões-dentistas, 72,5% eram do sexo feminino e 50,1% casados ou em união estável. A renda familiar de 66,1% profissionais foi igual ou superior a cinco salários mínimos e 55,9% relataram possuir especialização ou residência. Quanto ao local de atuação, 38,6% atuam tanto no setor público quanto no privado. Identificou-se comorbidades relacionadas ao agravamento da COVID-19 em 35,0% dos participantes, 24,5% não estão em dia com as vacinas de gripe e de hepatite, e 79,3% não foram testados para a COVID-19. No que diz respeito às instruções de biossegurança para COVID-19, 30,7% não receberam nenhum treinamento. Se faz necessário a imunização dos cirurgiões dentistas para doenças imunopreviníveis, ampliação da capacidade de testagem para a COVID-19, em especial aos profissionais pertencentes ao grupo de risco. Além de garantir a oferta de cursos de qualificação no tema da biossegurança, fundamental para a retomada segura das atividades.

Characterization of Dental Surgeons of Pernambuco State in the COVID-19 Pandemic Context: Preliminary Data

Abstract Objective: To present the results of preliminary research on the characterization of dental surgeons in the state of Pernambuco, during a pandemic of COVID-19. Material and Methods: This is a cross-sectional, descriptive, and exploratory study, whose population was composed of dental surgeons with active enrollment in the Regional Dentistry Council of Pernambuco. Data collection was performed using an electronic form and included characterization of professionals (gender, age, time since graduation, marital status, family income and field of work) and health status (vaccination schedule, presence of comorbidities, biosafety knowledge and testing for COVID-19). Preliminary data correspond to the first week of collection, which were analyzed from the frequency, proportions, and measures of central tendency distributions. Results: Of the 363 dental surgeons, for the field of work, 38.6% work in both the public and private sectors. Comorbidities related to the worsening of COVID-19 were identified in 35.0% of participants, 24.5% are not up to date with influenza and hepatitis vaccines, and 79.3% have not been tested for COVID-19. Regarding the biosafety instructions for COVID-19, 30.7% received no training. Conclusion: It is necessary to immunize dental surgeons to prevent immunological diseases and expansion of the testing capacity for COVID-19, especially for professionals belonging to the risk group. In addition to guaranteeing the offer of qualification courses on biosafety, which is essential for the safe resumption of activities.