Abstract This study aimed to make a longitudinal analysis of interexaminer calibration reproducibility in diagnosing dental caries in posterior teeth, by examiners without previous experience in epidemiological studies. A group of 11 inexperienced examiners underwent theoretical-practical training and calibration assessments, assisted by a standard examiner. An examiner who did not participate directly in the research selected 5-year-old children with and without caries. The D3 diagnostic threshold was used to evaluate dental caries, based on the World Health Organization (WHO) criteria. The initial calibration (baseline) was performed after the theoretical-practical training session, and consisted of examining 20 children; the second calibration occurred three months later, and involved evaluating another 18 children. The interexaminer agreement was obtained by kappa statistics, and by overall percentage agreement. The paired t-test was applied to compare the values for kappa means and overall percentage agreement between the time points studied. At baseline, the values for kappa (> 0.81) and overall percentage agreement (> 95.63%) were considered high. At the 3-month calibration assessment, all the examiners showed some decrease in both kappa (p < 0.0001) and overall percentage agreement (p = 0.0102). The calibration process currently proposed by the WHO is effective. However, reproducibility was not maintained over time for inexperienced examiners evaluating the posterior teeth of 5-year-old children, under epidemiological conditions.

ABSTRACT: Panoramic radiography has clinical importance in several dental specialties. The objective of this study was to evaluate the influence of professionals’ experience and patient characteristics (age group and dental absence) in the prevalence of errors and the number of retakes in the panoramic radiography.771 panoramic radiographs were evaluated and classified according to the group of patients (children, dentulous adults, total edentulous adults, and anterior edentulous adults) and professionals who performed the technique (novice and experienced). The association between frequency and type of error, group of patients, professionals’ experience, and number of retakes was performed by the Chi-square and Fisher’s exact test (a=0.05). There was no significant association between the frequency of errors or retakes of the radiograph s and the professionals’ experience or patients’ characteristics (p<0.05). The errors “turned head” and “tongue not against the palate,” “chin tipped low”, “chin not resting on the support,” “patient movement during exposure,” and “lead apron artifact” showed significantly higher frequency of retake (p<0.05). The most frequent type of error was due to the failure to position the tongue against the palate for all patients and both groups of professionals. The frequency of errors in the panoramic radiography occurs regardless of the professionals’ experience, and age and dental absence of the patients. Error occurs mainly due to the lack of patient collaboration, and the examination is rarely repeated by the professionals.

RESUMEN: La radiografía panorámica es de importancia clínica en varias especialidades dentales. El objetivo de este estudio fue evaluar la experiencia de los profesionales y las características de los pacientes (grupo etario y ausencia dentaria) en la prevalencia de errores y el número de repeticiones en la radiografía panorámica.771 radiografías panorámicas fueron evaluadas y clasificadas según la grupo de pacientes (niños, adultos desdentados, adultos desdentados totales y adultos desdentados anteriores) y profesionales que realizaron la técnica (novatos y experimentados). La asociación entre frecuencia y tipo de error, grupo de pacientes, experiencia de los profesionales y número de repeticiones se realizó mediante la prueba de Chicuadrado y exacta de Fisher (a = 0,05). No hubo asociación significativa entre la frecuencia de errores o repetición de las radiografías y la experiencia de los profesionales o las características de los pacientes (p <0,05). Los errores "cabeza girada" y "lengua no contra el paladar", "mentón inclinado hacia abajo", "mentón no apoyado en el soporte", "movimiento del paciente durante la exposición" y "artefacto del delantal de plomo" mostraron una frecuencia de repetición significativamente mayor (p < 0,05). El error más frecuente se debió a la falta de posicionamiento de la lengua contra el paladar para todos los pacientes y en ambos grupos de profesionales. La frecuencia de errores en la radiografía panorámica ocurre independientemente de la experiencia de los profesionales, edad y ausencia dentaria del pacientes. El error se produce principalmente por la falta de colaboración del paciente, y los profesionales rara vez repiten el examen.

Abstract Objective: To investigate association between parental locus of control (belief of individuals about what or who has control of the events of their lives) and bottle feeding habits among children from 3 to 5 years of age. Methodology: Parental locus of control validated in Brazil, and semi-structured questionnaire to obtain sociodemographic, health, and oral habit behaviors was applied to mothers of 992 preschool children. Outcome variable “use of feeding bottle” was studied according to the time of its use (≤36 months and >36 months). Simple logistic regression models were adjusted and raw odds ratios were estimated for variables of distal blocks, which contemplated parental locus of control, socioeconomic characteristics of family, and maternal habits. In the intermediate block, the variables for conditions of the child's birth and place of health care attendance during the prenatal period and early childhood were included. In the proximal block, the time of breastfeeding and pacifier use were reported. Variables were analyzed from the distal to the proximal block, and the individual analyses that presented p ≤ 0.20 remained in each model; included in the subsequent block were the variables with p ≤ 0.10, because this was a study of prevention. Results: Longer time of feeding bottle use was associated with the internal parental locus of control, mothers older than 31 years of age, white race, premature children, who used pacifiers and are treated in the private health system. Conclusions: Children who maintained the habit of feeding bottle use for a longer time were those whose mother presented an internal locus of control.

Resumo Analisou-se a resolutividade da atenção básica em saúde bucal nos municípios do estado da Paraíba, Brasil. Trata-se de um estudo transversal de abordagem indutiva, com procedimento comparativo e técnica de documentação indireta. O indicador de resolutividade (IR) constituiu da razão entre o número de tratamentos concluídos e primeiras consultas odontológicas programáticas dos municípios paraibanos (n = 223) entre 2011 e 2014, utilizando dados coletados da plataforma Datasus/TABNET. Foram consideradas variáveis explicativas: cobertura de primeira consulta odontoló gica programática (CPCOP), cobertura de equipes de atenção básica (CEAB), cobertura de equi pes de saúde bucal (CESB), cobertura de equipes de saúde da família (CESF), percentual de exodontia (PE), Produto Interno Bruto (PIB), Índice de Desenvolvimento Humano Municipal (IDHM) e coeficiente de Gini (CG). Os dados foram analisados por estatística descritiva e regressão múltipla binomial negativa (α = 0,05). As medianas do IR em 2011, 2012, 2013 e 2014 foram, respectivamente, 20,4, 17,5, 15,2 e 15,7. Houve associação positiva do IR com CPCOP (RP = 1,14; IC = 1,02-1,28), CEAB (RP = 1,02; IC = 1,01-1,03), e negativa com ano (RP = 0,83; IC = 0,74-0,94). A resolutividade em saúde bucal na atenção básica é influenciada por fatores relacionados à cobertura.

Abstract Oral health resolvability in primary care of municipalities in the State of Paraíba, Brazil, was analyzed, and a cross-sectional study was conducted, using an inductive approach, comparative procedure and indirect documentation. The Resolvability Indicator (RI) consisted of the ratio between the number of Completed Treatments and First Programmatic Dental Consultations in municipalities in Paraíba (n = 223), between 2011 and 2014, by using data collected from the DATASUS/TABNET platform. The following explanatory variables were considered: Coverage of First Programmatic Dental Consultation (CFPDC), Coverage of Primary Care Teams (CPCT), Coverage of Oral Health Teams (COHT), Coverage of Family Health Teams (CFHT), Percentage of Tooth Extraction (PTE), Gross Domestic Product (GDP), Municipal Human Development Index (MHDI) and Gini Coefficient (GC). Descriptive statistics and negative binomial multiple regression were performed (α = 0.05). The median RI in 2011, 2012, 2013 and 2014 was, respectively, 20.4, 17.5, 15.2 and 15.7. There was a positive association between RI and CFPDC (PR = 1.14, CI = 1.02-1.28), CPCT (PR = 1.02, CI = 1.01-1.03), in addition to a negative association. between RI and year (PR = 0.83; IC = 0.74-0.94). The resolvability of oral health in primary care is influenced by coverage-related factors.

Resumo Analisou-se a resolutividade da atenção básica em saúde bucal nos municípios do estado da Paraíba, Brasil. Trata-se de um estudo transversal de abordagem indutiva, com procedimento comparativo e técnica de documentação indireta. O indicador de resolutividade (IR) constituiu da razão entre o número de tratamentos concluídos e primeiras consultas odontológicas programáticas dos municípios paraibanos (n = 223) entre 2011 e 2014, utilizando dados coletados da plataforma Datasus/TABNET. Foram consideradas variáveis explicativas: cobertura de primeira consulta odontoló gica programática (CPCOP), cobertura de equipes de atenção básica (CEAB), cobertura de equi pes de saúde bucal (CESB), cobertura de equipes de saúde da família (CESF), percentual de exodontia (PE), Produto Interno Bruto (PIB), Índice de Desenvolvimento Humano Municipal (IDHM) e coeficiente de Gini (CG). Os dados foram analisados por estatística descritiva e regressão múltipla binomial negativa (α = 0,05). As medianas do IR em 2011, 2012, 2013 e 2014 foram, respectivamente, 20,4, 17,5, 15,2 e 15,7. Houve associação positiva do IR com CPCOP (RP = 1,14; IC = 1,02-1,28), CEAB (RP = 1,02; IC = 1,01-1,03), e negativa com ano (RP = 0,83; IC = 0,74-0,94). A resolutividade em saúde bucal na atenção básica é influenciada por fatores relacionados à cobertura.

Abstract Oral health resolvability in primary care of municipalities in the State of Paraíba, Brazil, was analyzed, and a cross-sectional study was conducted, using an inductive approach, comparative procedure and indirect documentation. The Resolvability Indicator (RI) consisted of the ratio between the number of Completed Treatments and First Programmatic Dental Consultations in municipalities in Paraíba (n = 223), between 2011 and 2014, by using data collected from the DATASUS/TABNET platform. The following explanatory variables were considered: Coverage of First Programmatic Dental Consultation (CFPDC), Coverage of Primary Care Teams (CPCT), Coverage of Oral Health Teams (COHT), Coverage of Family Health Teams (CFHT), Percentage of Tooth Extraction (PTE), Gross Domestic Product (GDP), Municipal Human Development Index (MHDI) and Gini Coefficient (GC). Descriptive statistics and negative binomial multiple regression were performed (α = 0.05). The median RI in 2011, 2012, 2013 and 2014 was, respectively, 20.4, 17.5, 15.2 and 15.7. There was a positive association between RI and CFPDC (PR = 1.14, CI = 1.02-1.28), CPCT (PR = 1.02, CI = 1.01-1.03), in addition to a negative association. between RI and year (PR = 0.83; IC = 0.74-0.94). The resolvability of oral health in primary care is influenced by coverage-related factors.

Resumo Introdução estudos no Brasil e em diversos países indicam que os serviços de urgência são frequentemente utilizados como portas de entrada para os sistemas de saúde, sobrecarregando-os e impactando na qualidade do serviço prestado à população. Entretanto, pouco se conhece sobre esse fenômeno nas unidades de pronto atendimento (UPAs) do nosso país. Objetivo investigar as variáveis associadas ao uso inadequado de duas UPAs em um município de grande porte. Método estudo transversal com uma amostra de 756 indivíduos que analisou as variáveis individuais, contextuais e dos serviços associadas ao uso inapropriado de UPAs por meio de um modelo de regressão logística múltipla e hierarquizada. Resultados o modelo final de regressão demonstrou que os indivíduos que apresentavam autopercepção de que sua condição era um caso de emergência e cuja idade era igual a ou acima de 60 anos apresentaram mais chances de procurarem esses serviços por motivos não urgentes. Conclusão variáveis individuais estiveram associadas ao uso não urgente dos serviços das UPAs. Estudos futuros de cunho qualitativo poderão auxiliar a compreender os motivos do uso inadequado desses serviços por tais indivíduos.

Abstract Background Studies in Brazil and in several countries indicate that emergency services are often used as gateways to health systems, overburdening them and impacting on the quality of service provided to the population. However, little is known about this phenomenon in the Emergency Care Units (EUCs) of our country. Objective To investigate the variables associated with the inadequate use of two EUCs in a large municipality. Method A cross-sectional study was carried out with a sample of 756 individuals that analyzed individual, contextual and service-related variables associated with the inappropriate use of EUCs through a hierarchical multiple logistic regression model. Results The final regression model showed that individuals who had self-perceived their condition as an emergency and whose age was equal to or older than 60 years presented high odds to seek these services for non-urgent reasons. Conclusions Individual variables were associated with non-urgent use of the ECUs. Future studies of a qualitative nature may help to understand the reasons for the inadequate use of these services by these individuals.

Abstract Objective: To make an association between self-perception and the implementation of sociodemographic variables for the autonomous and / or partially dependent individuals in nursing homes. Material and Methods: Epidemiological, observational and cross-sectional study. The sample consisted of 208 institutionalized elderly, both sexes, 60 years old or older, independent or partially dependent, randomly selected from two long-term residential institutions. Subjective evaluation: self-perception questionnaire, Geriatric Oral Health Assessment Index, quality of life assessment, Oral Impacts on Daily Performance (OIDP), oral health self-assessment (OH) and the need for dental prostheses. Bivariate analysis, chi-square test and multiple logistic regression were used, with the variables with p<0.05 remaining in the model. Results: Men were edentulous (53.43%), 68.75% used some type of denture, and 64.91% required dental prostheses, 60.58% self-assessed (OH) as good / excellent; who reported a need for dental prostheses presented 6.7 times (95% CI: 3.2-14.3) and more likely to have an impact on OIDP, those who needed prosthetics had a 2.8 times chance (95% CI: 1.3-6.1) (p<0.0001). The self-reported need for prostheses was associated with prevalence severity of impacts on QoL, eating, pronounce words correctly, Smile without feeling embarrassed; and the main reasons for not having badly adjusted teeth / dentures. Conclusion: The institutionalized elderly self-perceive the need for dental prostheses, but it does not have a negative impact on quality of life.

RESUMO: Introdução: O câncer de boca e o câncer de orofaringe são doenças influenciadas por fatores socioeconômicos. O risco de desenvolver essas doenças aumenta com a idade, e a maioria dos casos ocorre em idosos, com elevadas taxas de mortalidade. O objetivo deste estudo foi analisar a influência dos índices socioeconômicos municipais nas taxas de mortalidade por câncer de boca (CB) e de orofaringe (CO) em idosos nas 645 cidades do estado de São Paulo, Brasil, nos anos de 2013 a 2015. Método: Dados secundários de óbitos foram obtidos pelo Sistema de Informações sobre Mortalidade (SIM) do Ministério da Saúde. O número de idosos e os valores da renda média per capita e do índice de desenvolvimento humano por município (IDH-M) foram obtidos a partir dos dados da Fundação SEADE. Realizou-se a análise descritiva e exploratória dos dados, seguida de modelos binomiais negativos descritos pelo procedimento PROC GENMOD e avaliados pelo critério de informação de Akaike corrigido (AICc), pelo grau de liberdade e pelo teste de Wald (α=0,05). Resultados: Cerca de 30% das cidades notificaram óbitos em 2013, 16,74% em 2014 e 18,61% em 2015. Astaxas médias de mortalidade por CB e CO foram, respectivamente, de 20,0 (± 30,9) e 10,7 (± 17,5) por 100milhabitantes. A renda média variou de R$ 434,20 a R$ 2.009,00 e o IDH-M, de 0,65 a 0,89. Houve decréscimo significativo (p < 0,05) nas taxas de mortalidade por CB e CO em idosos com o aumento dos valores das rendas médias e do IDH-M. Conclusão: As desigualdades socioeconômicas das cidades influenciam nas taxas de mortalidade por CB e CO em idosos.

ABSTRACT: Introduction: Oral and oropharyngeal cancer are diseases strongly influenced by socioeconomic factors. The risk of developing these diseases increases with age and most cases occur in the elderly, with higher mortality rates. This study aimed to analyze the influence of municipal socioeconomic indices on mortality rates for oral (OC) and oropharyngeal cancer (OPC) in elderly residents from 645 cities in the State of São Paulo, Brazil, from 2013 to 2015. Method: Secondary data on deaths were obtained in the Mortality Information System from the Brazilian Ministry of Health. The number of elderly, as well as per capita median income values and Human Development Index by municipality (HDI-M) values were obtained from data by the SEADE Foundation. Descriptiveand exploratory analysis of data was performed, followed by negative binomial models described by the Proc Genmod procedure and evaluated by the corrected AIC (Akaike Information Criterion), the likelihood level, and the Wald test (α = 0.05). Results: Around 30% of the cities notified deaths in 2013, 16.74% in 2014, and 18.61% in 2015. Founded mortality mean rates from OC and OPC were, respectively, 20.0 (± 430.9) and 10.7 (± 17.5) deaths per 100,000 inhabitants. Meanincome ranged, in local currency, from 434.2 to 2,009.00. HDI-M ranged from 0.65 to 0.89. There was a significant decrease (p<0.05) in mortality rates for OC and OPC in elderly with the increase in the cities’ mean income and HDI-M values. Conclusion: Socioeconomic inequalities in the cities the on mortality rates for OC and OPC in elderly residents.

RESUMO: Introdução: O câncer de boca e o câncer de orofaringe são doenças influenciadas por fatores socioeconômicos. O risco de desenvolver essas doenças aumenta com a idade, e a maioria dos casos ocorre em idosos, com elevadas taxas de mortalidade. O objetivo deste estudo foi analisar a influência dos índices socioeconômicos municipais nas taxas de mortalidade por câncer de boca (CB) e de orofaringe (CO) em idosos nas 645 cidades do estado de São Paulo, Brasil, nos anos de 2013 a 2015. Método: Dados secundários de óbitos foram obtidos pelo Sistema de Informações sobre Mortalidade (SIM) do Ministério da Saúde. O número de idosos e os valores da renda média per capita e do índice de desenvolvimento humano por município (IDH-M) foram obtidos a partir dos dados da Fundação SEADE. Realizou-se a análise descritiva e exploratória dos dados, seguida de modelos binomiais negativos descritos pelo procedimento PROC GENMOD e avaliados pelo critério de informação de Akaike corrigido (AICc), pelo grau de liberdade e pelo teste de Wald (α=0,05). Resultados: Cerca de 30% das cidades notificaram óbitos em 2013, 16,74% em 2014 e 18,61% em 2015. Astaxas médias de mortalidade por CB e CO foram, respectivamente, de 20,0 (± 30,9) e 10,7 (± 17,5) por 100milhabitantes. A renda média variou de R$ 434,20 a R$ 2.009,00 e o IDH-M, de 0,65 a 0,89. Houve decréscimo significativo (p < 0,05) nas taxas de mortalidade por CB e CO em idosos com o aumento dos valores das rendas médias e do IDH-M. Conclusão: As desigualdades socioeconômicas das cidades influenciam nas taxas de mortalidade por CB e CO em idosos.

ABSTRACT: Introduction: Oral and oropharyngeal cancer are diseases strongly influenced by socioeconomic factors. The risk of developing these diseases increases with age and most cases occur in the elderly, with higher mortality rates. This study aimed to analyze the influence of municipal socioeconomic indices on mortality rates for oral (OC) and oropharyngeal cancer (OPC) in elderly residents from 645 cities in the State of São Paulo, Brazil, from 2013 to 2015. Method: Secondary data on deaths were obtained in the Mortality Information System from the Brazilian Ministry of Health. The number of elderly, as well as per capita median income values and Human Development Index by municipality (HDI-M) values were obtained from data by the SEADE Foundation. Descriptiveand exploratory analysis of data was performed, followed by negative binomial models described by the Proc Genmod procedure and evaluated by the corrected AIC (Akaike Information Criterion), the likelihood level, and the Wald test (α = 0.05). Results: Around 30% of the cities notified deaths in 2013, 16.74% in 2014, and 18.61% in 2015. Founded mortality mean rates from OC and OPC were, respectively, 20.0 (± 430.9) and 10.7 (± 17.5) deaths per 100,000 inhabitants. Meanincome ranged, in local currency, from 434.2 to 2,009.00. HDI-M ranged from 0.65 to 0.89. There was a significant decrease (p<0.05) in mortality rates for OC and OPC in elderly with the increase in the cities’ mean income and HDI-M values. Conclusion: Socioeconomic inequalities in the cities the on mortality rates for OC and OPC in elderly residents.

RESUMO OBJETIVO: Analisar se variáveis clínicas, sociodemográficas e de acesso aos serviços odontológicos influenciam o impacto da saúde bucal nas atividades diárias de adolescentes, adultos e idosos. MÉTODOS: Estudo transversal com dados secundários da Pesquisa Estadual de Saúde Bucal (SB São Paulo 2015) realizada em 163 municípios de São Paulo. Participaram do inquérito 17.560 indivíduos de três grupos etários: adolescentes de 15–19 anos (n = 5.558), adultos de 35–44 anos (n = 6.051) e idosos de 65 anos ou mais (n = 5.951). A seleção foi feita por amostra probabilística por conglomerados em dois estágios. A variável desfecho foi o impacto da saúde bucal sobre as atividades diárias, avaliado pelo questionário Oral Impacts on Daily Performances, contendo questões sobre comer, falar, higiene bucal, relaxamento, prática esportiva, sorriso, estudo ou trabalho, contato social e sono. O Oral Impacts on Daily Performances foi dicotomizado em com e sem impacto. As variáveis independentes foram as sociodemográficas, clínicas e de acesso, divididas em três blocos. Realizou-se análise de regressão logística múltipla hierarquizada considerando o plano amostral complexo de conglomerados. Cada observação recebeu um peso específico, dependendo da localização que resultou em frequências ponderadas e ajustadas para o efeito do delineamento. RESULTADOS: A presença de impacto da saúde bucal foi constatada em 27,9% dos indivíduos. No bloco 1, o sexo feminino e o grupo étnico preto/pardo tiveram maior chance de impacto da saúde bucal na qualidade de vida, bem como os adultos e idosos em relação aos adolescentes. No bloco 2, a renda familiar até R$1.500 teve associação com a presença de impacto. No bloco 3, os indivíduos que relataram dor de dente, frequentaram o serviço público e procuraram tratamento odontológico tiveram maior chance de impacto. CONCLUSÕES: As variáveis sociodemográficas, clínica e de acesso ao serviço de saúde influenciam o impacto da saúde bucal nas atividades diárias de adolescentes, adultos e idosos.

ABSTRACT OBJECTIVE: Analyze if clinical, sociodemographic and access to dental services variables influence the impact of oral health on the daily activities of adolescents, adults and older adults. METHODS: A cross-sectional study with secondary data from the State Oral Health Survey (SB São Paulo 2015) conducted in 163 cities of São Paulo. A total of 17,560 individuals from three age groups: 15–19-year-old (n = 5,558), 35–44-year-old (n = 6,051), and older people of 65 years or more (n = 5,951) participated in the survey. The selection was made by probabilistic sample by conglomerates in two stages. The endpoint variable was the impact of oral health on daily activities, evaluated by the Oral Impacts on Daily Performances questionnaire, containing questions about eating, talking, oral hygiene, relaxation, sports practice, smile, study or work, social contact, and sleep. Oral Impacts on Daily Performances was dichotomized with and without impact. The independent variables were sociodemographic, clinical and access variables, divided into three blocks. A hierarchical multiple logistic regression analysis was performed considering the complex sampling plan of clusters. Each observation received a specific weight, depending on the location that resulted in weighted frequencies and adjusted for the design effect. RESULTS: The presence of oral health impact was observed in 27.9% of the individuals. In block 1, female gender and black/brown ethnic group had a greater chance of impact of oral health on quality of life, as well as the adults and the older adults in relation to adolescents. In block 2, family income up to R$1,500 was associated with the presence of impact. In block 3, individuals who reported toothache, used the public service and sought dental treatment had a greater chance of impact. CONCLUSIONS: Sociodemographic, clinical and access to health services variables influence the impact of oral health on the daily activities of adolescents, adults and older adults.

RESUMO OBJETIVO: Analisar se variáveis clínicas, sociodemográficas e de acesso aos serviços odontológicos influenciam o impacto da saúde bucal nas atividades diárias de adolescentes, adultos e idosos. MÉTODOS: Estudo transversal com dados secundários da Pesquisa Estadual de Saúde Bucal (SB São Paulo 2015) realizada em 163 municípios de São Paulo. Participaram do inquérito 17.560 indivíduos de três grupos etários: adolescentes de 15–19 anos (n = 5.558), adultos de 35–44 anos (n = 6.051) e idosos de 65 anos ou mais (n = 5.951). A seleção foi feita por amostra probabilística por conglomerados em dois estágios. A variável desfecho foi o impacto da saúde bucal sobre as atividades diárias, avaliado pelo questionário Oral Impacts on Daily Performances, contendo questões sobre comer, falar, higiene bucal, relaxamento, prática esportiva, sorriso, estudo ou trabalho, contato social e sono. O Oral Impacts on Daily Performances foi dicotomizado em com e sem impacto. As variáveis independentes foram as sociodemográficas, clínicas e de acesso, divididas em três blocos. Realizou-se análise de regressão logística múltipla hierarquizada considerando o plano amostral complexo de conglomerados. Cada observação recebeu um peso específico, dependendo da localização que resultou em frequências ponderadas e ajustadas para o efeito do delineamento. RESULTADOS: A presença de impacto da saúde bucal foi constatada em 27,9% dos indivíduos. No bloco 1, o sexo feminino e o grupo étnico preto/pardo tiveram maior chance de impacto da saúde bucal na qualidade de vida, bem como os adultos e idosos em relação aos adolescentes. No bloco 2, a renda familiar até R$1.500 teve associação com a presença de impacto. No bloco 3, os indivíduos que relataram dor de dente, frequentaram o serviço público e procuraram tratamento odontológico tiveram maior chance de impacto. CONCLUSÕES: As variáveis sociodemográficas, clínica e de acesso ao serviço de saúde influenciam o impacto da saúde bucal nas atividades diárias de adolescentes, adultos e idosos.

ABSTRACT OBJECTIVE: Analyze if clinical, sociodemographic and access to dental services variables influence the impact of oral health on the daily activities of adolescents, adults and older adults. METHODS: A cross-sectional study with secondary data from the State Oral Health Survey (SB São Paulo 2015) conducted in 163 cities of São Paulo. A total of 17,560 individuals from three age groups: 15–19-year-old (n = 5,558), 35–44-year-old (n = 6,051), and older people of 65 years or more (n = 5,951) participated in the survey. The selection was made by probabilistic sample by conglomerates in two stages. The endpoint variable was the impact of oral health on daily activities, evaluated by the Oral Impacts on Daily Performances questionnaire, containing questions about eating, talking, oral hygiene, relaxation, sports practice, smile, study or work, social contact, and sleep. Oral Impacts on Daily Performances was dichotomized with and without impact. The independent variables were sociodemographic, clinical and access variables, divided into three blocks. A hierarchical multiple logistic regression analysis was performed considering the complex sampling plan of clusters. Each observation received a specific weight, depending on the location that resulted in weighted frequencies and adjusted for the design effect. RESULTS: The presence of oral health impact was observed in 27.9% of the individuals. In block 1, female gender and black/brown ethnic group had a greater chance of impact of oral health on quality of life, as well as the adults and the older adults in relation to adolescents. In block 2, family income up to R$1,500 was associated with the presence of impact. In block 3, individuals who reported toothache, used the public service and sought dental treatment had a greater chance of impact. CONCLUSIONS: Sociodemographic, clinical and access to health services variables influence the impact of oral health on the daily activities of adolescents, adults and older adults.

ABSTRACT OBJECTIVE To identify and analyze factors associated with preventable child deaths. METHODS This analytical cross-sectional study had preventable child mortality as dependent variable. From a population of 34,284 live births, we have selected a systematic sample of 4,402 children who did not die compared to 272 children who died from preventable causes during the period studied. The independent variables were analyzed in four hierarchical blocks: sociodemographic factors, the characteristics of the mother, prenatal and delivery care, and health conditions of the patient and neonatal care. We performed a descriptive statistical analysis and estimated multiple hierarchical logistic regression models. RESULTS Approximatelly 35.3% of the deaths could have been prevented with the early diagnosis and treatment of diseases during pregnancy and 26.8% of them could have been prevented with better care conditions for pregnant women. CONCLUSIONS The following characteristics of the mother are determinant for the higher mortality of children before the first year of life: living in neighborhoods with an average family income lower than four minimum wages, being aged ≤ 19 years, having one or more alive children, having a child with low APGAR level at the fifth minute of life, and having a child with low birth weight.

ABSTRACT OBJECTIVE To identify and analyze factors associated with preventable child deaths. METHODS This analytical cross-sectional study had preventable child mortality as dependent variable. From a population of 34,284 live births, we have selected a systematic sample of 4,402 children who did not die compared to 272 children who died from preventable causes during the period studied. The independent variables were analyzed in four hierarchical blocks: sociodemographic factors, the characteristics of the mother, prenatal and delivery care, and health conditions of the patient and neonatal care. We performed a descriptive statistical analysis and estimated multiple hierarchical logistic regression models. RESULTS Approximatelly 35.3% of the deaths could have been prevented with the early diagnosis and treatment of diseases during pregnancy and 26.8% of them could have been prevented with better care conditions for pregnant women. CONCLUSIONS The following characteristics of the mother are determinant for the higher mortality of children before the first year of life: living in neighborhoods with an average family income lower than four minimum wages, being aged ≤ 19 years, having one or more alive children, having a child with low APGAR level at the fifth minute of life, and having a child with low birth weight.

RESUMO Objetivo: Descrever o perfil da violência notificada contra crianças e adolescentes e realizar um ensaio sobre os efeitos iniciais da Lei nº 13.010 no padrão das notificações. Método: Estudo analítico dos casos registrados no SINAN - Sistema de Informação de Agravos de Notificação (2013 a 2015) de violência a menores de 19 anos, em 53 municípios de Minas Gerais. Resultados: Foram notificados 1.481 casos, 49,2% antes e 50,8% depois da lei (p = 0,5501). Houve uma diminuição das notificações de 7% no sexo feminino e aumento de 27,2% no masculino (p = 0,0055). Verificou-se modificação no padrão das notificações (p = 0,0023), com o aumento de 130,7% em negligência/abandono e diminuição de 33% no abuso sexual. Maior violência por pai e mãe ocorre nas faixas de 1 a 9 anos (p < 0,0001). Conclusão: As principais vítimas foram mulheres, indivíduos de 15 a 19 anos, e agressões ocorrendo na residência; nota-se, após a Lei, mudanças no padrão do perfil da vítima e do agressor e no tipo de violência.

ABSTRACT Objective: Describing the profile of reported violence against children and adolescents and draw an essay on the initial effects of Law 13.010 on report patterns. Method: Analytic study of reported cases on SINAN - Information System on Reportable Harms (from 2013 to 2015) of violence to individuals under 19, in 53 cities of Minas Gerais. Results: 1,481 cases were reported, 49.2% before and 50.8% after Law 13.010 came to force (p = 0.5501). There was a 7% decrease on female reports and a 27.2% in male reports (p = 0.0055). It was noticed a change in report patterns (p = 0.0023), with a 130.7% increase to neglect/abandonment reports and a 33% decrease to sexual abuse report. Higher rates of violence from the parents happens at the 1 to 9-year-old age group (p < 0.0001). Conclusion: Main victims were women, individuals from 15 to 19 years, with aggression happening within the household; after Law 13.010, changes to patterns of victim and offender profiles and of kind of violence were noticed.

RESUMEN Objetivo: Describir el perfil de la violencia notificada contra niños y adolescentes y realizar un ensayo sobre los efectos iniciales de la Ley nº 13.010 en el patrón de las notificaciones. Método: Estudio analítico de los casos registrados en el SINAN - Sistema de Información de Enfermedades de Declaración Compulsória (2013 a 2015) de violencia a menores de 19 años, en 53 municipios de Minas Gerais. Resultados: Se notificaron 1.481 casos, 49,2% antes y 50,8% después de la ley (p=0,5501). Se observó una disminución de las notificaciones del 7% en el sexo femenino y un aumento del 27,2% en el masculino (p=0,0055). Se verificó una modificación en el patrón de las notificaciones (p=0,0023), con el aumento del 130,7% en negligencia/abandono y disminución del 33% en el abuso sexual. La mayor violencia por padre y madre ocurre en las franjas de 1 a 9 años (p<0,0001). Conclusión: Las principales víctimas fueron mujeres, individuos de 15 a 19 años, y agresiones ocurriendo en la residencia; se nota, después de la Ley, cambios en el patrón del perfil de la víctima y del agresor y en el tipo de violencia.

ABSTRACT Objective: Describing the profile of reported violence against children and adolescents and draw an essay on the initial effects of Law 13.010 on report patterns. Method: Analytic study of reported cases on SINAN - Information System on Reportable Harms (from 2013 to 2015) of violence to individuals under 19, in 53 cities of Minas Gerais. Results: 1,481 cases were reported, 49.2% before and 50.8% after Law 13.010 came to force (p = 0.5501). There was a 7% decrease on female reports and a 27.2% in male reports (p = 0.0055). It was noticed a change in report patterns (p = 0.0023), with a 130.7% increase to neglect/abandonment reports and a 33% decrease to sexual abuse report. Higher rates of violence from the parents happens at the 1 to 9-year-old age group (p < 0.0001). Conclusion: Main victims were women, individuals from 15 to 19 years, with aggression happening within the household; after Law 13.010, changes to patterns of victim and offender profiles and of kind of violence were noticed.

RESUMEN Objetivo: Describir el perfil de la violencia notificada contra niños y adolescentes y realizar un ensayo sobre los efectos iniciales de la Ley nº 13.010 en el patrón de las notificaciones. Método: Estudio analítico de los casos registrados en el SINAN - Sistema de Información de Enfermedades de Declaración Compulsória (2013 a 2015) de violencia a menores de 19 años, en 53 municipios de Minas Gerais. Resultados: Se notificaron 1.481 casos, 49,2% antes y 50,8% después de la ley (p=0,5501). Se observó una disminución de las notificaciones del 7% en el sexo femenino y un aumento del 27,2% en el masculino (p=0,0055). Se verificó una modificación en el patrón de las notificaciones (p=0,0023), con el aumento del 130,7% en negligencia/abandono y disminución del 33% en el abuso sexual. La mayor violencia por padre y madre ocurre en las franjas de 1 a 9 años (p<0,0001). Conclusión: Las principales víctimas fueron mujeres, individuos de 15 a 19 años, y agresiones ocurriendo en la residencia; se nota, después de la Ley, cambios en el patrón del perfil de la víctima y del agresor y en el tipo de violencia.

RESUMO Objetivo: Descrever o perfil da violência notificada contra crianças e adolescentes e realizar um ensaio sobre os efeitos iniciais da Lei nº 13.010 no padrão das notificações. Método: Estudo analítico dos casos registrados no SINAN - Sistema de Informação de Agravos de Notificação (2013 a 2015) de violência a menores de 19 anos, em 53 municípios de Minas Gerais. Resultados: Foram notificados 1.481 casos, 49,2% antes e 50,8% depois da lei (p = 0,5501). Houve uma diminuição das notificações de 7% no sexo feminino e aumento de 27,2% no masculino (p = 0,0055). Verificou-se modificação no padrão das notificações (p = 0,0023), com o aumento de 130,7% em negligência/abandono e diminuição de 33% no abuso sexual. Maior violência por pai e mãe ocorre nas faixas de 1 a 9 anos (p < 0,0001). Conclusão: As principais vítimas foram mulheres, indivíduos de 15 a 19 anos, e agressões ocorrendo na residência; nota-se, após a Lei, mudanças no padrão do perfil da vítima e do agressor e no tipo de violência.