Evidence related to the use of therapeutic play on anxiety and behavior of children undergoing invasive procedures is still questionable. The absence, in most studies, of the creation of a random sequence to assign the subjects to either the control or the experimental group, as well as allocation concealment, are factors that contribute to these questions. Another issue that characterizes an important source of bias is the absence of blinded evaluators. It is necessary to perform further studies that will take into account greater methodological stringency.

ResumoObjetivo: Analisar as evidências científicas publicadas relacionadas à acessibilidade de pessoas idosas aos serviços de saúde bucal. Metodologia: Utilizaram-se as bases de dados MEDLINE, LILACS e BBO, empregando como descritores: "idoso", "saúde bucal" e "acesso aos serviços de saúde". A busca ocorreu de forma online em pares, incluindo artigos originais na língua portuguesa, inglesa ou espanhola abordando o tema proposto, publicados no período de janeiro de 2005 a novembro de 2012. Resultados: Mostram estudos em diversos países, os quais referem que a fonte regular de cuidados odontológicos é identificada como fator facilitador para a utilização recente dos serviços. Portanto, apontam a necessidade de ampliar o acesso da população idosa a ações e serviços de saúde bucal, associados principalmente a questões socioeconômicas e culturais. Conclusão: É fundamental garantir o acesso e motivar a procura pelo serviço entre idosos, esclarecendo à população a necessidade e a importância do uso de serviços odontológicos. AbstractAim: To analyze the scientific evidence published, relating to accessibility of elderly to oral health services. Methodolog y: Databases MEDLINE, LILACS, BBO were used, employing as descriptors: "elderly", "oral health", "health services accessibility". The search was conducted online in pairs including original articles in Portuguese, English or Spanish on the study theme published between January 2005 and November, 2012. Results: Showed studies in several countries, which refer to the regular source of dental care identified as facilitating factor for the recent use of services. Therefore, they point the need to expand the elderly's access to actions and oral health services, mainly associated socioeconomic and cultural issues. Conclusion: It is essential to ensure access and motivate the demand for service between dentate and edentulous elderly, explaining to the people the need and importance of attending dental services.

Considering that emergency dental services include the referral network and the counter-referral network, interacting at the intersection between primary, secondary and tertiary healthcare, this study aims to describe the interface between primary healthcare (APS - Atenção Primária a Saúde), particularly of the Family Health Strategy, and secondary care in oral health, using the Emergency Dental Services (SOU), in the municipality of Recife. It is a qualitative, exploratory and descriptive case study. The data was collected through semi-structured interviews. Classical ALCESTE analysis was used based on the Descending Hierarchical Classification Dendrogram, making it possible to understand the expressions and each one of the words spoken by the dental health professionals, analyzing them using their social places and contexts as a starting point. What we found was only a fragile degree of integration, and little capacity for solution, between the levels of care - a partially disconnected network. Undoubtedly the problems with the interface between primary care and the emergency services in oral health are multiple and complex. The individual solutions have low efficacy, and are complex in their operation.

Resumo Este estudo investigou a mediação da autoestima nos comportamentos de saúde bucal dos adolescentes. Para avaliar a autoestima usou-se a escala de Rosenberg, já as características sociodemográficas e comportamentais foram analisadas por questões validadas em outros inquéritos. Com exceção da alimentação, a maior proporção dos adolescentes possuía bons comportamentos de saúde bucal. O número de adolescentes com alto nível de autoestima foi relevantemente menor que aqueles com baixa autoestima. A utilização dos serviços odontológicos, embora associado ao alto nível de autoestima, perdeu significância após ajustado pelo sexo, idade e escovação dos dentes. Porém, a análise de regressão logística múltipla, através das estimativas não-ajustadas e ajustadas com seus respectivos Intervalos de Confiança de 95%, evidenciou associação da autoestima com idade (p-valor=0,001) e frequência de escovação (p-valor=0,019). Independente do sexo, escolares maiores de 16 anos e com autoestima elevada, escovam seus dentes com maior frequência, adquirindo, possivelmente, melhor saúde bucal. Isto confirma a modulação da autoestima sobre os comportamentos de saúde bucal, e atesta a necessidade de implementar a análise e o exercício desse fator psicossocial na assistência à saúde bucal dos jovens.

Objetivo: Avaliar, sob a ótica de gestores/gerentes e profissionais, a qualidade dos Serviços Odontológicos de Urgência (SOU) da cidade do Recife, Brasil. Métodos: A coleta de dados foi por meio de questionários e as análises estatísticas foram do tipo exploratória-descritivo. Resultados: Os aspectos estruturais do serviço foram considerados satisfatórios, bem como evidenciado que há disponibilidade de prontuários, entretanto destaca-se a inexistência de protocolo clínico. Quanto ao perfil de atendimento, de acordo com os profissionais, 87,5% citaram como queixa principal a dor dentária, sendo a abertura coronária o procedimento mais realizado (59,4%). No que tange à referência e contrarreferência, o acesso ao SOU se dá exclusivamente pela demanda espontânea, e há garantia de referência para serviços de maior complexidade. Quanto ao monitoramento e avaliação do próprio serviço, 66,6% dos gestores desconhecem a existência de metas de produção para avaliação do SOU, 77,8% não estabelecem e/ou utilizam de mecanismos para avaliar o grau de satisfação do usuário com o serviço e não sabe se há no Plano Orçamento Anual, metas ou rubricas financeiras ao SOU. Conclusão: Os SOU da cidade do Recife/PE, de acordo com informações colhidas junto aos gestores e profissionais, cumprem o seu papel de atendimento de urgência.Avaliação de serviços de saúde; Saúde bucal; Urgência. Objective:To evaluate the quality of Urgent Dental Services Units (UDS) in Recife, PE, Brazil from the point of view of health managers/supervisors and professionals was evaluated. Method: Data collection was undertaken by questionnaires and statistical analyses were exploratory and descriptive. Results: The structural aspects of the UDS were considered satisfactory and clinical files were easily available even though it should be highlighted the lack of clinical protocols. In the opinion of professionals with regard to dental care profile, complaints on toothache were prevalent (87.5%) and coronal access was the most performed procedure (59.4%). As far as reference and counter-reference are concerned, exclusively spontaneous demand characterized the access of the population to the UDS. There is a reference guarantee for services of higher complexity. With regards to follow up and evaluation of the services, 66.6% of the managers are not aware of productivity targets for UDS evaluation and 77.8% do not establish or use mechanisms to evaluate the level of users' satisfaction with regard to the services offered at the units. Neither do they know whether there are targets or financial assets in the UDS Annual Budget Plan. Conclusion:According to information collected from managers/supervisors and professionals, the UDS of the city of Recife comply with their role in urgent dental care.Evaluation of health services; Oral health; Urgency.

Since the co-occurrence of several health-risk behaviors is associated with an increase in chronic diseases, the study of clustering is relevant. The aim of this study was to evaluate how seven types of general and oral health-risk behaviors, cluster among adolescents. A cross-sectional analysis was performed with a sample of high school students from state public schools in São Lourenco da Mata, State of Pernambuco, Brazil (n = 1154). Data were obtained using a self-reported questionnaire. To identify cluster solutions of seven general and oral health-risk behaviors, Hierarchical Agglomerative Cluster Analysis (HACA) was performed. Most of the adolescents participating in the study was female (54.3%) and aged <16 years old (77.1%). HACA indicated two broad stable clusters for the seven health-risk types of behaviors. The first cluster included following behaviors: smoking, drinking and less frequent tooth brushing. The second cluster reveals the combination of high bread, pasta and snack intake; high intake of sweets; high intake of soft drinks; low intake of fruits and vegetables. Results provided by HACA identified two groups of health-risk behaviors. The first cluster mainly shows risk (problematic) behaviors, whereas the second cluster denotes the non-adhesion of preventive behavior (non-healthy diet). Health-compromising behaviors are common among teens and occur in distinct clusters. These findings could be used by schools, health promotion authorities and other stakeholders to design and implement tailored preventive interventions in Pernambuco, Brazil. Therefore, clustering of several types of behavior has important implications for a comprehensive strategy in health promotion policies and practices.

Objective: To identify the profile of aged outpatients attended at the Núcleo de Atenção ao Idoso and the variables that interfere on duration of stay in the service. Methods: A quantitative, descriptive, cross-sectional research was carried through, based on the analysis of 1,194 medical reports of aged outpatients attended from 2000 up to 2004. The variables were: sociodemographic data, clinical registers in medical evaluation and duration of stay of the aged outpatients at the clinic. A logistic regression was performed to analyze the relation between clinical variables and time of stay. Results: Women (76.5%) were more numerous than men (23.5%), in all age intervals. According to scholarship, 12.9% were illiterate and the most prevalent category (37.1%) had incomplete first degree. The number of aged widower women (38%) was three times those of widower men (12%). The majority of aged (94.4%) had a company of housing and 84.4% did not have health plan. The mean duration of stay in the service was 2 years and 8 months, with standard deviation of 1.5 years. The variables with major influence on duration of stay were: age, dizziness complaints, refractive, hearing and urinary disturbances, cataract, and bone fractures. Conclusions: According to the logistic regression, surgical history, hearing and urinary disturbances, as well as bone fractures contributed to increase duration of stay, but dizziness complaints, refractive disturbances and cataract reduced the stay of the elderly in the service.

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