In recent years, studies investigating psychological states such as happiness in individuals’ health have increased. Aim This study investigated a possible association between self-perceived oral health and happiness in university students. Methods This cross-sectional study was performed in a cohort of university students who entered in the 2016 academic year at the Federal University of Pelotas, located in southern Brazil. Data were collected using a self-administered questionnaire, including demographic and socioeconomic characteristics, psychosocial traits, and oral health-related questions. Happiness was measured through a question accompanied by the Faces Scale of Andrews and Whitey. Poisson regression models with robust variance were used to assess the association between the exposure variables (oral health measures) and the outcome (happiness). Results The prevalence of happiness was 48.6%. A significant association between happiness and oral health, including satisfaction with dental appearance (PR 1.86; 95% CI 1.73-2.01), oral health-related to quality of life (PR 1.19; 95% CI 1.09-1.31), and halitosis (PR 1.10; 95% CI 1.01-1.20), was found. Conclusion Individuals who reported dissatisfaction with dental appearance, an impact on oral health-related to quality of life, and halitosis perceived themselves as unhappy. years individuals increased selfperceived self crosssectional cross sectional 201 Pelotas Brazil selfadministered administered questionnaire characteristics traits healthrelated related questions Whitey measures happiness. . (happiness) 486 48 6 48.6% PR 1.86 186 1 86 95 1.732.01, 173201 1.73 2.01 , 73 2 01 1.73-2.01) 1.19 119 19 1.091.31, 109131 1.09 1.31 09 31 1.09-1.31) 1.10 110 10 1.011.20, 101120 1.01 1.20 20 1.01-1.20) found unhappy (happiness 4 48.6 1.8 18 8 9 732 1.732.01 17320 173 1.7 2.0 7 0 1.73-2.01 1.1 11 091 1.091.31 10913 109 1.0 131 1.3 3 1.09-1.31 011 1.011.20 10112 101 120 1.2 1.01-1.20 48. 1. 1.732.0 1732 17 2. 1.73-2.0 1.091.3 1091 13 1.09-1.3 1.011.2 1011 12 1.01-1.2 1.732. 1.73-2. 1.091. 1.09-1. 1.011. 1.01-1. 1.732 1.73-2 1.091 1.09-1 1.011 1.01-1 1.73- 1.09- 1.01-

Aim The present study aimed to investigate if cannabis use can be associated with gingival bleeding and caries experience among Brazilian students. Methods A cross-sectional study was performed in 2016 with first-semester university students in Pelotas. Data was collected via a self-administered questionnaire. Self-reported gingival bleeding and caries experienced were collected. Cannabis use was assessed using a modified version of the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST). We define cannabis users as individuals who report using cannabis at least once a month. A Poisson regression model with robust variance was used to analyze the data. Results A total of 2,058 (64.5% of eligible students) students were assessed. The prevalence of caries experience was 68.2% and gingival bleeding was 50.8%. The prevalence of cannabis use was 11.7%. After controlling (sex, skin color, age, family income, depressive symptoms, oral health self-perception tobacco use), individuals who use cannabis present a prevalence of gingival bleeding 2.51 (CI95%[1.42–4;53]) higher than individuals who did not use cannabis. The association was maintained even when the individuals who used tobacco were excluded from the sample (PR=2.24, CI95%[1.16 – 4.31]). Cannabis use did not show an association with the experience of dental caries in both crude (PR 0.91 CI95%[0.82 – 1.01]) and adjusted models (PR 0.93 CI 95%[0.83 – 1.05]). Conclusion Cannabis use was associated with the presence of gingival bleeding among the students of a public university in the south of Brazil. However, the experience of dental caries did not present an association with cannabis use. crosssectional cross sectional 201 firstsemester first semester Pelotas selfadministered self administered questionnaire Selfreported Self reported Alcohol Smoking ASSIST. ASSIST . (ASSIST) month data 2058 2 058 2,05 64.5% 645 64 5 (64.5 682 68 68.2 508 50 8 50.8% 117 11 7 11.7% sex, sex (sex color age income symptoms selfperception perception use, , use) 251 51 2.5 CI95%1.42–453 CI95142453 CI95% 1.42–4 53 CI95 1 42 4 (CI95%[1.42–4;53] PR=2.24, PR224 PR 24 (PR=2.24 CI95%1.16 CI95116 1.16 16 CI95%[1.1 4.31. 431 4.31 31 4.31]) 091 0 91 0.9 CI95%0.82 CI95082 0.82 82 CI95%[0.8 1.01 101 01 1.01] 093 93 95%0.83 95083 95% 0.83 95 83 95%[0.8 1.05. 105 1.05 05 1.05]) Brazil However 20 (ASSIST 205 2,0 64.5 6 (64. 68. 50.8 11.7 25 2. 453 CI95%1.42–45 CI9514245 1424 1.42– CI9 (CI95%[1.42–4;53 PR=2.24 PR22 (PR=2.2 CI95%1.1 CI9511 116 1.1 CI95%[1. 43 4.3 3 4.31] 09 9 0. CI95%0.8 CI9508 082 0.8 CI95%[0. 1.0 10 95%0.8 9508 083 95%[0. 1.05] 2, 64. (64 50. 11. 45 CI95%1.42–4 CI951424 142 1.42 (CI95%[1.42–4;5 PR=2.2 PR2 (PR=2. CI95%1. CI951 1. CI95%[1 4. CI95%0. CI950 08 CI95%[0 95%0. 950 95%[0 (6 CI95%1.42– CI95142 14 1.4 (CI95%[1.42–4; PR=2. (PR=2 CI95%1 CI95%[ CI95%0 95%0 95%[ ( CI95%1.42 CI9514 (CI95%[1.42–4 PR=2 (PR= CI95%1.4 (CI95%[1.42– PR= (CI95%[1.42 (CI95%[1.4 (CI95%[1. (CI95%[1 (CI95%[ (CI95% (CI95 (CI9 (CI

Abstract The present study aimed to investigate the contextual inequalities of specialized public dental care (SPDC) in Brazil. The outcome was the trajectory of dental specialized production in municipalities with SPDC (from 2015 to 2017) obtained by group-based trajectory modeling. A Poisson regression model was used to analyze the factors associated with the high trajectory of SPDC production. The inequality indicators for SPDC production were the slope index and the concentration index according to contextual factors. The study included 954 SPDC units distributed across 893 municipalities. Among the municipalities evaluated, 62.9% had a low trajectory of SPDC. Large-sized municipalities had the highest production (IRR = 2.84, 95%CI: 1.94–4.14) and the southern region had the lowest production (IRR = 0.73, 95%CI: 0.58–0.92). Municipalities presenting a very high human development index (HDI) showed the greatest SPDC production (IRR = 3.34, 95%CI: 1.09–10.24), as well as municipalities with the highest tertile of schooling rate (IRR = 1.23, 95%CI: 1.00–1.50). The absolute inequality was 52.1 percentage points for the average monthly wage (p < 0.001), 61.0 percentage points for the HDI (p < 0.001), -22.1 for infant mortality rate (p <0.001), and 14.8 for the schooling rate (p = 0.012). Thus, there are contextual inequalities in the Brazilian SPDC. Higher scores for social indicators were associated with better SPDC performance. (SPDC Brazil from 201 2017 groupbased group based modeling 95 89 evaluated 629 62 9 62.9 Largesized Large sized IRR 284 2 84 2.84 95%CI 95CI CI 1.94–4.14 194414 1 94 4 14 073 0 73 0.73 0.58–0.92. 058092 0.58–0.92 . 58 92 0.58–0.92) (HDI 334 3 34 3.34 1.09–10.24, 1091024 1.09–10.24 , 09 10 24 1.09–10.24) 123 23 1.23 1.00–1.50. 100150 1.00–1.50 00 50 1.00–1.50) 521 52 52. p 0.001, 0001 0.001 001 0.001) 610 61 61. 22.1 221 22 -22. <0.001, <0.001 <0.001) 148 8 14. 0.012. 0012 0.012 012 0.012) Thus performance 20 6 62. 28 2.8 1.94–4.1 19441 07 7 0.7 05809 0.58–0.9 5 33 3.3 109102 1.09–10.2 12 1.2 10015 1.00–1.5 000 0.00 22. -22 <0.00 0.01 01 2. 1.94–4. 1944 0. 0580 0.58–0. 3. 10910 1.09–10. 1. 1001 1.00–1. 0.0 -2 <0.0 1.94–4 194 058 0.58–0 1091 1.09–10 100 1.00–1 - <0. 1.94– 19 05 0.58– 109 1.09–1 1.00– <0 1.94 0.58 1.09– 1.00 1.9 0.5 1.09 1.0

Aim The study aimed to evaluate the association between oral health and academic performance and/or school absenteeism. Methods Electronic searches were performed of the PubMed, Web of Science, SCOPUS and LILACS/BVS databases. We included observational studies that evaluated the association between dental caries, tooth loss, dental pain or oral health status with school absenteeism or academic performance. The studies had to contain a representative sample of the population: schoolchildren, children or adolescents. After the removal of duplicates, the electronic searches produced 3,789 articles. Of these, 25 studies were included in the systematic review and 13 in the meta-analysis. Results Considering all the studies evaluated in the meta-analysis, seven articles satisfied 100% of the Joanna Briggs Institute Critical Appraisal checklist, and six contained between 90% and 75% positive answers. The pooled effects showed that the chances of school absenteeism were 31% higher in subjects with dental caries (OR 1.31; 95%CI 1.12-1.54). Students with fair/poor dental health had a 50% higher chance of suffering poor academic performance (OR 1.50; 95%CI 1.22-1.84) and 34% higher chance of having problems at school (OR 1.34; 95%CI 1.06-1.70). Students with a history of toothache had a 3.7 higher chance of being absent from school (OR 6.65; 95%CI 1.60-8.32) and 71% higher chance of missing class due to toothache (OR 1.71; 95%CI 1.15-2.56). Subjects with a history of toothache had a 2.5 times higher chance of suffering poor academic performance (OR 2.58; 95% CI 2.04-3.27). Conclusion Therefore, students with oral problems were more likely to take time off school and present inferior academic performance. andor PubMed Science LILACSBVS LILACS BVS databases loss population schoolchildren adolescents duplicates 3789 3 789 3,78 these 2 1 metaanalysis. metaanalysis meta analysis. analysis meta-analysis metaanalysis, analysis, 100 checklist 90 75 answers 31 OR 1.31 131 95CI 95 1.121.54. 112154 1.12 1.54 . 12 54 1.12-1.54) fairpoor fair 50 1.50 150 1.221.84 122184 1.22 1.84 22 84 1.22-1.84 34 1.34 134 1.061.70. 106170 1.06 1.70 06 70 1.06-1.70) 37 7 3. 6.65 665 6 65 1.608.32 160832 1.60 8.32 60 8 32 1.60-8.32 71 1.71 171 1.152.56. 115256 1.15 2.56 15 56 1.15-2.56) 5 2. 2.58 258 58 2.043.27. 204327 2.04 3.27 04 27 2.04-3.27) Therefore 378 78 3,7 10 9 1.3 121 1.121.54 11215 112 1.1 154 1.5 1.12-1.54 221 1.221.8 12218 122 1.2 184 1.8 1.22-1.8 061 1.061.70 10617 106 1.0 170 1.7 0 1.06-1.70 6.6 66 608 1.608.3 16083 160 1.6 832 8.3 1.60-8.3 17 152 1.152.56 11525 115 256 1.15-2.56 043 2.043.27 20432 204 2.0 327 3.2 2.04-3.27 3, 1. 1.121.5 1121 11 1.12-1.5 1.221. 1221 18 1.22-1. 1.061.7 1061 1.06-1.7 6. 1.608. 1608 16 83 8. 1.60-8. 1.152.5 1152 1.15-2.5 2.043.2 2043 20 2.04-3.2 1.121. 1.12-1. 1.221 1.22-1 1.061. 1.06-1. 1.608 1.60-8 1.152. 1.15-2. 2.043. 2.04-3. 1.121 1.12-1 1.22- 1.061 1.06-1 1.60- 1.152 1.15-2 2.043 2.04-3 1.12- 1.06- 1.15- 2.04-

Aim Venous blood derivatives (VBDs) have been suggested as substitutes for Fetal Bovine Serum (FBS) to improve the clinical transition of cell-based therapies. The literature is not clear about which is the best VBDs substitute. The present study aimed to evaluate the influence of VBDs on cell viability and describe a new method to seed these cells in a 3D Platelet-Rich Fibrin (PRF). Methods Blood was processed to obtain Platelet-Poor Plasma from PRF (P-PRF), Human Serum (HS), Platelet-Poor Plasma from PRP (P-PRP), activated-PRP (a-PRP), and Platelet lysate (PL). Cells were supplemented with each VBD at 10% and FBS at 10% was the control. Cell viability (fibroblast 3T3/NIH) test was evaluated with MTT assay in two ways: i) cell-seeded and expanded with VBD; ii) cell-seed with FBS and expanded with VBD. To seed the Fibrin construct, cells were suspended in PBS and dropped into the blood sample before performing Choukroun’s protocol for PRF. Constructs were cultured for 7 days in VBD supplements and FBS. Histological and Immunohistochemical analysis with vimentin was performed. Cell viability was analyzed by one-way ANOVA. Results VBD’s production time was very heterogeneous. Cells expanded in HS and a-PRP has grown faster. VBD-supplemented culture media provided cell culture highly sensible to trypsin/EDTA 0.25%. Cells seeded and expanded with VBD presented viability comparable to FBS in HS, a-PRP, and P-PRP (p>0.05) and lower in P-PRF and PL groups (p<0.05). The viability of cell seed with FBS and expanded with VBD was similar between P-PRF, a-PRP, PL, and FBS (p>0.05) and lower in HS and P-PRP (p<0.005). PRF-seeded cells showed a positive expression of vimentin and were able to maintain all cells supplemented with VBD. Conclusion VBD supplements were able to maintain fibroblast cells in 2D and 3D cultures. The new method of the fibrin-cell construct was efficient to insert the cells into the fibrin network. (VBDs (FBS cellbased based therapies substitute D PlateletRich Rich . (PRF) PlateletPoor Poor PPRF, PPRF P , (P-PRF) (HS) PPRP, PPRP (P-PRP) activatedPRP activated aPRP, aPRP (a-PRP) PL. (PL) 10 control 3T3/NIH 3T3NIH TNIH 3T3 NIH T ways i cellseeded ii cellseed Choukrouns Choukroun s performed oneway one way ANOVA heterogeneous faster VBDsupplemented trypsinEDTA trypsin EDTA 025 0 25 0.25% PRP, p>0.05 p005 p 05 (p>0.05 p<0.05. p<0.05 (p<0.05) PRF, p<0.005. p0005 p<0.005 005 (p<0.005) PRFseeded cultures fibrincell network (PRF (P-PRF (HS (P-PRP (a-PRP (PL 1 3T 02 2 0.25 p>0.0 p00 (p>0.0 p<0.0 (p<0.05 p000 p<0.00 00 (p<0.005 0.2 p>0. p0 (p>0. p<0. (p<0.0 (p<0.00 0. p>0 (p>0 p<0 (p<0. p> (p> p< (p<0 (p (p<

Abstract The present study aimed to investigate the prevalence of dissatisfaction with dental appearance among 24-year-old Brazilian adults and the associated factors in life course. A subsample (n = 720) of the 1982 Pelotas Birth Cohort in southern Brazil was investigated at the ages of 15 and 24 years using clinical (caries and periodontal) examinations and interviews. The outcome was dissatisfaction with dental appearance at the age of 24 years. Covariate variables included socioeconomic factors, oral health, and dissatisfaction with general appearance collected during different periods of life. Poisson regression models with robust variance were applied. The prevalence of dissatisfaction with dental appearance was 43.5% (95%CI: 39.8–47.1). Individuals with downward income mobility (PR = 1.22, 95%CI: 1.07–1.79) and those always poor (PR = 1.21, 95%CI: 1.00–1.57) presented a higher prevalence of dissatisfaction with their dental appearance even after oral health variables and dissatisfaction with general appearance were controlled for. Moderate/severe malocclusion at 15 years (PR = 1.34, 95%CI: 1.13–1.59), highest experience of untreated dental caries at 24 years (PR = 1.82, 95%CI: 1.46–2.27), and dental pain experience at 24 years (PR = 1.29, 95%CI: 1.22–1.75) were associated with the outcome. Also, the prevalence of dissatisfaction with dental appearance was 20% higher (PR = 1.20, 95%CI: 1.01–1.43) among those dissatisfied with their general appearance. Our findings demonstrated a high prevalence of dissatisfaction with dental appearance among young adults. Lifetime economic disadvantage and dental problems (malocclusion at 15 years, untreated dental caries at 24 years, and dental pain at 24 years) were associated with dissatisfaction with dental appearance among young adults. 24yearold yearold year old course n 720 198 1 2 periodontal interviews applied 435 43 5 43.5 95%CI 95CI CI 95 (95%CI 39.8–47.1. 398471 39.8–47.1 . 39 8 47 39.8–47.1) PR 122 22 1.22 1.07–1.79 107179 07 79 121 21 1.21 1.00–1.57 100157 00 57 for Moderatesevere Moderate severe 134 34 1.34 1.13–1.59, 113159 1.13–1.59 , 13 59 1.13–1.59) 182 82 1.82 1.46–2.27, 146227 1.46–2.27 46 27 1.46–2.27) 129 29 1.29 1.22–1.75 122175 75 Also 20 120 1.20 1.01–1.43 101143 01 72 19 4 43. 9 39847 39.8–47. 3 12 1.2 1.07–1.7 10717 0 7 1.00–1.5 10015 1.3 11315 1.13–1.5 18 1.8 14622 1.46–2.2 1.22–1.7 12217 1.01–1.4 10114 3984 39.8–47 1. 1.07–1. 1071 1.00–1. 1001 1131 1.13–1. 1462 1.46–2. 1.22–1. 1221 1.01–1. 1011 398 39.8–4 1.07–1 107 1.00–1 100 113 1.13–1 146 1.46–2 1.22–1 1.01–1 101 39.8– 1.07– 10 1.00– 11 1.13– 14 1.46– 1.22– 1.01– 39.8 1.07 1.00 1.13 1.46 1.01 39. 1.0 1.1 1.4

The study investigated the factors associated with the self-perception safety of dental students in clinical activities during the COVID-19 pandemic. This cross-sectional study was based on a semi-structured online (google forms) self-applied questionnaire, sent by e-mail to three private Dental Schools in Brazil. The variables were: 1) sociodemographic information; 2) questions about the measures adopted by dental schools before returning to clinical activities; 3) dental students’ self-perception of security; 4) the General Health Questionnaire. Data were submitted to Fisher’s exact test (p<0.05). Of the 294 eligible students, 97% were evaluated and 100% received previous specific biosafety training predominantly theoretical (72.16%) longer than one hour (51.55%). Most students (81.44%) felt secure performing clinical care during the COVID-19 pandemic. Students undergoing specific biosafety training for longer than one hour felt safer than those perfoming training for up to 1 hour (p=0.004). Students from schools where the aerosol-producing restriction was applied felt safer than those without restrictions (p=0.016). Women reported feeling less secure than men (p=0.046), and students who submitted to COVID-19 Specific Biosafety Training felt safer in clinical activities than those submitted to theoretical training only (p=0.011). Students from private universities presenting psychosomatic changes felt less secure in practicing clinical dental care activities (p=0.006). In conclusion, time-spent training in biosafety, restriction of the use of aerosol-producing procedures, and the gender of students were associated with the self-perception safety of students. Students with practical training felt safer in clinical activities for patients with COVID-19 than those who had only theoretical training.

ABSTRACT Aim The aim of our study was to analyze the content related to dentistry published on Instagram ® and to investigate the students’ profiles related to the use of social networks in a sample from a Dentistry School. Methods This study was carried out in two stages. First, research was conducted to analyze content published on Instagram® related to dentistry. The second part investigated the profiles of students’ from a dental school in relation to the use of social networks through a questionnaire. A descriptive analysis was performed and associations between the variables were tested using Fisher’s exact test. Results We found a diversified and large amount of content related to dentistry published on Instagram ® , and publications that involved advertising were more prevalent in our study. There are also many publications that are violating the Code of Dental Ethics. In addition, in the second part of our study, we observed an enormous use of social networks by dental students (98.4%). Conclusions As a result, we believe that it is important to update professionals about the ethical infractions related to social networks which could be approached during graduate courses in universities. Finally, the analyzed social network seems to be an interesting alternative for disseminating health information in order to dialogue with greater proximity to the large number of users who participate in it.

Aim In Brazil, COVID-19 remains one of the epicenters of the pandemic, thus, presential educational activities are suspended. The study aimed to describe the approach of flipped classroom performed to provide social distancing and to maintain teaching activities during COVID-19-pandemic. Methods Flipped Classroom was chosen to be associated with the role-play technique as a central methodology. To bring students closer to activities performed in the non-pandemic period, some actions and assessments were also role-played by Professor simulating patients in virtual meetings. Results Although the changes in the format of the lessons, our approaches stimulated the students maintained the high frequency of students in the activities (almost 100%) providing continuity activities. Conclusions This report can reinforce that meaningful learning can be taught by using a virtual/remote approach. However, the potential positive results observed cannot be used as an excuse to maintain remote teaching activities with the objective of cost-cutting by the institutions.

Resumo O objetivo deste estudo é descrever o perfil de utilização dos serviços de atenção primária à saúde, estimado pela Pesquisa Nacional de Saúde (PNS), da população residente em domicílios cadastrados e não cadastrados na Estratégia de Saúde da Família (ESF), nos anos de 2013 e 2019. Estudo transversal realizado com microdados dos inquéritos nacionais de saúde entre 2013 e 2019. A amostra originou-se de uma amostra mestra, composta por um conjunto de unidades de áreas selecionadas em um cadastro. Variáveis sexo, idade, cor da pele, renda, escolaridade, autopercepção de saúde, domicílio cadastrado na ESF, atendimento médico no último ano, tipo de serviço que você procura quando está doente foram selecionados. As variáveis dependentes foram uso de serviços de saúde e uso de serviços públicos de saúde. As variáveis dependentes e independentes foram descritas com os respectivos intervalos de confiança e foi realizada regressão logística ajustada para cada desfecho analisado. Nos serviços públicos de saúde, menor renda, ter doenças crônicas (hipertensão arterial ou colesterol alto), estar grávida e ter uma autopercepção de saúde ruim estiveram associados à maior utilização de serviços de saúde nos dois períodos. Morar em domicílios cadastrados na ESF foi associado aos serviços de saúde mais utilizados (públicos ou privados). A estratégia de saúde da família é uma estratégia importante para expandir o acesso de forma igualitária.

Abstract The objective of this study is to describe the profile of use of primary health care services, estimated by the PNS, of the population living in households registered and not registered with the Famly Health Strategy - FHS, in the years 2013 and 2019. Cross-sectional study carried out using microdata from national health surveys 2013 and 2019. The sample originated from a master sample, consisting of a set of units from selected areas in a register..The variables sex, age, skin color, income, education, self-perceived health, home registered with the FHS, medical care in the last year, type of service you seek when you are ill were selected. The dependent variables were use of health services and use of public health services. The dependent and independent variables were described with the respective confidence interval and adjusted logistic regression was performed for each outcome analyzed. In public health services, lower income, have chronic diseases (arterial hypertension or high cholesterol), be pregnant, and having a bad self-perception of health were associated with used more health services in both periods. Living in registered households was associated with more used health services (public or private). The family health strategy is an important strategy for expanding access equally.

Resumo O objetivo deste estudo é descrever o perfil de utilização dos serviços de atenção primária à saúde, estimado pela Pesquisa Nacional de Saúde (PNS), da população residente em domicílios cadastrados e não cadastrados na Estratégia de Saúde da Família (ESF), nos anos de 2013 e 2019. Estudo transversal realizado com microdados dos inquéritos nacionais de saúde entre 2013 e 2019. A amostra originou-se de uma amostra mestra, composta por um conjunto de unidades de áreas selecionadas em um cadastro. Variáveis sexo, idade, cor da pele, renda, escolaridade, autopercepção de saúde, domicílio cadastrado na ESF, atendimento médico no último ano, tipo de serviço que você procura quando está doente foram selecionados. As variáveis dependentes foram uso de serviços de saúde e uso de serviços públicos de saúde. As variáveis dependentes e independentes foram descritas com os respectivos intervalos de confiança e foi realizada regressão logística ajustada para cada desfecho analisado. Nos serviços públicos de saúde, menor renda, ter doenças crônicas (hipertensão arterial ou colesterol alto), estar grávida e ter uma autopercepção de saúde ruim estiveram associados à maior utilização de serviços de saúde nos dois períodos. Morar em domicílios cadastrados na ESF foi associado aos serviços de saúde mais utilizados (públicos ou privados). A estratégia de saúde da família é uma estratégia importante para expandir o acesso de forma igualitária.

Abstract The objective of this study is to describe the profile of use of primary health care services, estimated by the PNS, of the population living in households registered and not registered with the Famly Health Strategy - FHS, in the years 2013 and 2019. Cross-sectional study carried out using microdata from national health surveys 2013 and 2019. The sample originated from a master sample, consisting of a set of units from selected areas in a register..The variables sex, age, skin color, income, education, self-perceived health, home registered with the FHS, medical care in the last year, type of service you seek when you are ill were selected. The dependent variables were use of health services and use of public health services. The dependent and independent variables were described with the respective confidence interval and adjusted logistic regression was performed for each outcome analyzed. In public health services, lower income, have chronic diseases (arterial hypertension or high cholesterol), be pregnant, and having a bad self-perception of health were associated with used more health services in both periods. Living in registered households was associated with more used health services (public or private). The family health strategy is an important strategy for expanding access equally.

Objectives: the purpose of this study was to describe the impact of the COVID-19 pandemic on Primary Health Care in Brazil. Methods: This retrospective ecological study was carried out using Brazilian municipality data obtained from the information systems of the National Public Health System. The outcomes were medical appointments, prenatal procedures and diabetes care. The exposure variable was the occurrence of the COVID-19 pandemic, based on the first case notified in Brazil. Multilevel mixed-effects negative binomial regression was used to analyze the association between the number of procedures per 10,000 inhabitants and COVID-19. Results: Data from 5,564 Brazilian municipalities were included in the present study. Regarding medical appointments, the largest reduction occasioned by the pandemic occurred in May (IRR = 0.27, CI 95% [0.24 – 0.30]). As far as prenatal procedures are concerned, the reduction was 65% (IRR= 0.35, CI 95% [0.32 – 0.38], also in May. In addition, diabetes care saw the biggest reductions in April 2020 (IRR = 0.24, CI 95% [0.11 – 0.53]) and May 2020 (IRR = 0.19, CI 95% [0.09 – 0.43]). From February to December 2020, the pandemic had a significant effect on the total number of procedures evaluated. Conclusion: The findings showed a reduction in prenatal procedures, diabetes and medical consultations performed in Brazil’s Primary Health Care, subsequent to the onset of the COVID-19 pandemic.

Objetivos: o objetivo do estudo foi descrever o impacto da pandemia COVID-19 na Atenção Primária à Saúde Brasileira. Métodos: Estudo ecológico retrospectivo realizado com dados de municípios Brasileiros dos sistemas de informação do Sistema Único de Saúde. Os desfechos do estudo foram as consultas médicas, procedimentos de pré-natal e tratamento de diabetes. A exposição foi a ocorrência da pandemia de COVID-19, a partir do primeiro caso notificado no Brasil. Regressões binomiais negativas de efeitos mistos multinível foram utilizadas para analisar a associação entre o número de procedimentos por 10.000 habitantes e a pandemia de COVID-19. Resultados: Dados de 5.564 municípios brasileiros foram incluídos no presente estudo. Em relação à consulta médica, a maior redução devido à pandemia ocorreu em maio (IRR = 0,27, IC 95% [0,24 - 0,30]). Para os procedimentos de pré-natal, a redução foi de 65% (IRR= 0.35, IC 95% [0.32 – 0.38]) em maio. Ainda assim, os procedimentos de tratamento do diabetes tiveram maiores reduções em abril (IRR = 0,24, IC 95% [0,11 - 0,53]) e maio (IRR = 0,19, IC 95% [0,09 - 0,43]) de 2020. De fevereiro a dezembro de 2020 a pandemia impactou significantemente no total de procedimentos avaliados. Conclusão: Os achados mostraram uma redução de procedimentos de pré-natal, diabetes e consultas médicas realizadas na Atenção Primária à Saúde do Brasil, após o início da pandemia de COVID-19.

Resumo: O estudo teve como objetivo comparar a necessidade normativa de prótese dentária (estimada por dentista) com a necessidade subjetiva (autorrelatada), testando a acurácia e concordância e comparando a direção e magnitude das associações com variáveis independentes, usando necessidade normativa e subjetiva como os desfechos. Foi avaliada uma amostra representativa de uma coorte de nascimentos (n = 900), aos 31 anos de idade. A necessidade subjetiva foi obtida com um questionário. As variáveis necessidade normativa e subjetiva foram analisadas dicotomicamente como: (a) com necessidade de prótese dentária e (b) sem necessidade de prótese dentária. A acurácia foi avaliada enquanto sensibilidade (SE), especificidade (SP), valor preditivo positivo (VPP) e valor preditivo negativo (VPN). A concordância entre necessidade normativa e subjetiva foi avaliada com a estimativa do índice kappa. Sexo, renda, escolaridade, uso de serviços de odontologia e percepção da própria saúde oral foram usados para comparar as associações entre necessidade normativa e subjetiva. A prevalência de necessidade normativa era 48,9% e de necessidade subjetiva, 34,9%. A concordância (kappa: 0,43) e acurácia entre as necessidades normativa e subjetiva de prótese dentária eram baixas (SE: 56,5, IC95%: 50,3-62,6; SP: 85,8, IC95%: 81,1-89,7; VPP: 79,1, IC95%: 72,6-84,7; VPN: 67,3, IC95%: 62,1-72,2). Nos indivíduos com perda de dentes anteriores, os resultados mostraram boa concordância (kappa: 0,82) e acurácia entre necessidade normativa e subjetiva (SE: 93,3, IC95%: 68,1-99,8; SP: 88,9, IC95%: 51,8-99,7; VPP: 93,3, IC95%: 68,1-99,8; VPN: 88,9, IC95%: 51,8-99,7). A direção e magnitude das associações com necessidade normativa e subjetiva eram semelhantes. Portanto, a necessidade normativa de prótese dentária difere da necessidade subjetiva em adultos, exceto quando há perda de dentes anteriores.

Abstract: The aim of our study was to compare normative need for dental prosthesis (estimated by dentists) with subjective need (self-reported) by testing the accuracy and agreement and comparing direction and magnitude of associations with independent variables using both as outcomes. A representative sample of a birth cohort study (n = 900) was assessed at 31 years of age. Subjective need was obtained from questionnaire. Both normative and subjective need variables were dichotomized in (a) individuals with need for dental prosthesis and (b) without need for dental prosthesis. Accuracy was assessed by sensitivity (SE), specificity (SP), positive (PPV) and negative (NPV) predictive values. Agreement of normative and subjective need was assessed estimating kappa index. Sex, income, educational level, use of dental services and self-reported oral health were used to compare the associations with normative and subjective need. Prevalence of normative need was 48.9% and subjective need was 34.9%. Agreement (kappa: 0.43) and accuracy between normative and subjective need for dental prosthesis was low (SE: 56.5, 95%CI: 50.3-62.6; SP: 85.8, 95%CI: 81.1-89.7; PPV: 79.1, 95%CI: 72.6-84.7; NPV: 67.3, 95%CI: 62.1-72.2). When considering individuals with loss in anterior teeth, results showed a good agreement (kappa: 0.82) and accuracy between normative and subjective need (SE: 93.3, 95%CI: 68.1-99.8; SP: 88.9, 95%CI: 51.8-99.7; PPV: 93.3, 95%CI: 68.1-99.8; NPV: 88.9, 95%CI: 51.8-99.7). Direction and magnitude of associations with normative and subjective need were similar. Thus, normative need for dental prosthesis differs from subjective need in adults, except when anterior losses are present.

Resumen: El objetivo de este estudio fue comparar la necesidad normativa de prótesis detal -estimada por los dentistas- con la necesidad subjetiva -autoinformada-, probando la precisión y concordancia, así como comparando la dirección y magnitud de asociaciones con variables independientes, usando ambas como resultados. Se evaluó una muestra representativa de un estudio de cohorte de nacimientos (n = 900) a los 31 años de edad. La necesidad subjetiva procede de un cuestionario. Ambas variables necesidad normativa y subjetiva fueron dicotomizadas en (a) individuos con necesidad de una prótesis dental y (b) sin necesidad de una prótesis dental. La precisión se evaluó por sensibilidad (SE), especificidad (SP), valores predictivos positivos (PPV) y negativos (NPV). La concordancia entre necesidad normativa y subjetiva se evaluó estimando el índice de kappa. Sexo, ingresos, nivel educacional, uso de servicios dentales y autoinformados de salud oral se usaron para comparar las asociaciones con necesidad normativa y subjetiva. La prevalencia de necesidad normativa fue 48,9% y la de necesidad subjetiva fue 34,9%. Concordancia (kappa: 0,43) y precisión entre la necesidad normativa y subjetiva de prótesis dental fue baja (SE: 56,5, IC95%: 50,3-62,6; SP: 85,8, IC95%: 81,1-89,7; PPV: 79,1, IC95%: 72,6-84,7; NPV: 67,3, IC95%: 62,1- 72,2). Cuando consideramos a individuos con pérdidas de dientes anteriores, los resultados mostraron una buena concordancia (kappa: 0,82) y precisión entre necesidad normativa y subjetiva (SE: 93,3, IC95%: 68,1-99,8; SP: 88,9, IC95%: 51,8-99,7; PPV: 93,3, IC95%: 68,1-99,8); NPV: 88,9, IC95%: 51,8-99,7). La dirección y magnitud de las asociaciones con necesidad normativa y subjetiva fueron similares. Por lo tanto, la necesidad normativa de prótesis dentales difiere de la necesidad subjetiva en adultos, excepto cuando están presentes las pérdidas de dientes anteriores.

RESUMO: Objetivos: O objetivo do presente estudo foi descrever o impacto da pandemia de covid-19 na Atenção Primária à Saúde (APS) Brasileira. Métodos: Estudo ecológico retrospectivo realizado com dados de municípios brasileiros, obtidos nos sistemas de informação do Sistema Único de Saúde (SUS). Os desfechos do estudo foram as consultas médicas, procedimentos de pré-natal e tratamento de diabetes. A exposição foi a ocorrência da pandemia de covid-19, a partir do primeiro caso notificado no Brasil. Regressões binomiais negativas de efeitos mistos multinível foram utilizadas para analisar a associação entre o número de procedimentos por 10.000 habitantes e a pandemia de covid-19. Resultados: Dados de 5.564 municípios brasileiros foram incluídos no presente estudo. Em relação à consulta médica, a maior redução devido à pandemia em curso ocorreu em maio (IRR = 0,27, IC95% 0,24 - 0,30). Para os procedimentos de pré-natal, a redução foi de 65% (IRR = 0,35, IC95% 0.32 - 0.38), também em maio. Ainda assim, os procedimentos de tratamento do diabetes tiveram maiores reduções em abril (IRR = 0,24, IC95% 0,11 - 0,53) e maio (IRR = 0,19, IC95% 0,09 - 0,43) de 2020. De fevereiro a dezembro de 2020, a pandemia de covid-19 impactou significantemente o total de procedimentos avaliados. Conclusão: Os achados mostraram uma redução de procedimentos de pré-natal, diabetes e consultas médicas realizadas na Atenção Primária à Saúde (APS) do Brasil, após o início da pandemia de covid-19.

ABSTRACT: Objectives: The purpose of this study was to describe the impact of the COVID-19 pandemic on Primary Health Care in Brazil. Methodology: This retrospective ecological study was carried out using Brazilian municipality data obtained from the information systems of the National Public Health System. The outcomes were medical appointments, prenatal procedures and diabetes care. The exposure variable was the occurrence of the COVID-19 pandemic, based on the first case reported in Brazil. Multilevel mixed-effects negative binomial regression was used to analyze the association between the number of procedures per 10,000 inhabitants and COVID-19. Results: Data from 5,564 Brazilian municipalities were included in the present study. Regarding medical appointments, the largest reduction occasioned by the pandemic occurred in May (IRR = 0.27, 95%CI 0.24 – 0.30). Prenatal procedures were reduced by 65% (IRR = 0.35, 95%CI 0.32 – 0.38), also in May. In addition, diabetes care saw the biggest reductions in April 2020 (IRR = 0.24, 95%CI 0.11 – 0.53) and May 2020 (IRR = 0.19, 95%CI 0.09 – 0.43). From February to December 2020, the pandemic had a significant effect on the total number of procedures evaluated. Conclusion: The findings showed a reduction in prenatal procedures, diabetes and medical consultations performed in Brazil's Primary Health Care, following the onset of the COVID-19 pandemic.

RESUMO: Objetivos: O objetivo do presente estudo foi descrever o impacto da pandemia de covid-19 na Atenção Primária à Saúde (APS) Brasileira. Métodos: Estudo ecológico retrospectivo realizado com dados de municípios brasileiros, obtidos nos sistemas de informação do Sistema Único de Saúde (SUS). Os desfechos do estudo foram as consultas médicas, procedimentos de pré-natal e tratamento de diabetes. A exposição foi a ocorrência da pandemia de covid-19, a partir do primeiro caso notificado no Brasil. Regressões binomiais negativas de efeitos mistos multinível foram utilizadas para analisar a associação entre o número de procedimentos por 10.000 habitantes e a pandemia de covid-19. Resultados: Dados de 5.564 municípios brasileiros foram incluídos no presente estudo. Em relação à consulta médica, a maior redução devido à pandemia em curso ocorreu em maio (IRR = 0,27, IC95% 0,24 - 0,30). Para os procedimentos de pré-natal, a redução foi de 65% (IRR = 0,35, IC95% 0.32 - 0.38), também em maio. Ainda assim, os procedimentos de tratamento do diabetes tiveram maiores reduções em abril (IRR = 0,24, IC95% 0,11 - 0,53) e maio (IRR = 0,19, IC95% 0,09 - 0,43) de 2020. De fevereiro a dezembro de 2020, a pandemia de covid-19 impactou significantemente o total de procedimentos avaliados. Conclusão: Os achados mostraram uma redução de procedimentos de pré-natal, diabetes e consultas médicas realizadas na Atenção Primária à Saúde (APS) do Brasil, após o início da pandemia de covid-19.

ABSTRACT: Objectives: The purpose of this study was to describe the impact of the COVID-19 pandemic on Primary Health Care in Brazil. Methodology: This retrospective ecological study was carried out using Brazilian municipality data obtained from the information systems of the National Public Health System. The outcomes were medical appointments, prenatal procedures and diabetes care. The exposure variable was the occurrence of the COVID-19 pandemic, based on the first case reported in Brazil. Multilevel mixed-effects negative binomial regression was used to analyze the association between the number of procedures per 10,000 inhabitants and COVID-19. Results: Data from 5,564 Brazilian municipalities were included in the present study. Regarding medical appointments, the largest reduction occasioned by the pandemic occurred in May (IRR = 0.27, 95%CI 0.24 – 0.30). Prenatal procedures were reduced by 65% (IRR = 0.35, 95%CI 0.32 – 0.38), also in May. In addition, diabetes care saw the biggest reductions in April 2020 (IRR = 0.24, 95%CI 0.11 – 0.53) and May 2020 (IRR = 0.19, 95%CI 0.09 – 0.43). From February to December 2020, the pandemic had a significant effect on the total number of procedures evaluated. Conclusion: The findings showed a reduction in prenatal procedures, diabetes and medical consultations performed in Brazil's Primary Health Care, following the onset of the COVID-19 pandemic.