BackgroundWorkers in Primary Health Care are often exposed to stressful conditions at work. This study investigated the association between adverse psychosocial work conditions and poor quality of life among Primary Health Care workers.MethodsThis cross-sectional study included all 797 Primary Health Care workers of a medium-sized city, Brazil: doctors, nurses, nursing technicians and nursing assistants, dentists, oral health technicians, and auxiliary oral hygienists, and community health workers. Data were collected by interviews. Quality of life was assessed using the WHOQOL-BREF; general quality of life, as well as the physical, psychological, social and environmental domains were considered, with scores from 0 to 100. Higher scores indicate a better quality of life. Poor quality of life was defined by the lowest quartiles of the WHOQOL score distributions for each of the domains. Adverse psychosocial work conditions were investigated by the Effort-Reward Imbalance model. Associations were verified using multiple logistic regression.ResultsPoor quality of life was observed in 117 (15.4%) workers. Workers with imbalanced effort-reward (high effort/low reward) had an increased probability of general poor quality of life (OR = 1.91; 1.07–3.42), and in the physical (OR = 1.62; 1.02–2.66), and environmental (OR = 2.39; 1.37–4.16) domains; those with low effort/low reward demonstrated a greater probability of poor quality of life in the social domain (OR = 1.82; 1.00–3.30). Workers with overcommitment at work had an increased likelihood of poor quality of life in the physical (OR = 1.55, 1.06–2.26) and environmental (OR = 1.69; 1.08–2.65) domains. These associations were independent of individual characteristics, job characteristics, lifestyle, perception of general health, or psychological and biological functions.ConclusionsThere is an association between adverse psychosocial work conditions and poor quality of life among Primary Health Care workers.

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a low proportion of filling was observed, especially in PHC and other services.

Background: Health education during pregnancy is important to improve maternal and children outcomes. However, the strategies must be specifically designed for each context and demographic characteristics. Our objective was identify health education strategies targeting pregnant women with the intention of improving results of pregnancy at an urban level. Methods: We conducted a scoping review of the literature to answer the question: “what health education strategies targeting pregnant women were reported by primary healthcare teams or the community promoting health in pregnancy, childbirth, postpartum and childhood?” Potential eligible studies were selected using PubMed, Web of Science, LILACS and SciELO by 2 reviewers. Results: From a total of 3105 articles, 23 were deemed eligible. We identified 9 educational methodologies focusing on different outcomes of pregnancy, birth or maternal wellbeing. Conclusions: It is important that health education strategies continue after childbirth, independent of the strategy. All the strategies presented in this review are suitable for transfer with a moderate chance of success of implementation or improvement of current education methodologies. Further research is required on health education, including a higher number of patients.

IntroductionThe aim of this study was to assess inequality of experience of dental caries, based on race/ethnicity, among Brazilian adolescents aged 15 to 19 years in 2010 and test whether socioeconomic indicators fully explain ethnic differences in dental caries.MethodsData from a National Oral Health Survey conducted in Brazil in 2010 was analysed. Race/ethnicity was self-assigned and modified to White, African descents, East Asian descents, Mixed Race and Indigenous descents. The prevalence of caries experience by race/ethnic group in 2010(n = 5,367) was calculated. Further analysis included conceptual hierarchical modelling and mediation analysis.ResultsCaries experience was 76.9% in 15 to 19 year old Brazilians in 2010. While African descents were 32% more likely to have caries experience than Whites, Mixed Race were 69% more likely to have caries experience than Whites. Hierarchical conceptual modelling analysis confirmed the highly significant association between caries and race/ethnicity. Mixed Race and East Asian descents were 1.44 (95% CI 1.24–1.67) and 1.81 (95% CI 1.02–3.20) times more likely to experience caries than Whites after adjusting for age, sex, education and income. The difference in the likelihood of experiencing caries between Whites and African descents was not statistically significant after adjusting for years of education and family income. The results of mediation analysis confirmed that inequality of caries experience between Whites and Mixed Race and East Asian descents was mediated through education and income. The likelihood that Mixed Race and East Asian descents would experience caries compared to Whites was attenuated, by 14.8% and by 9.5% respectively, after adjusting for years of education and income.ConclusionsData analysis demonstrated that Whites have benefited more from the significant reduction in dental caries experience in 15 to 19 year old Brazilians, as compared to African descents and Mixed Race. Education and income fully explained ethnic inequalities in experience of dental caries between Whites and African descents, and largely explained inequalities between Whites and Mixed Race.

OBJECTIVE:To assess the association between the prevalence of malocclusion in Brazilian 12 years-olds with individual and contextual variables. METHODS:A cross-sectional, analytical study was conducted with data from the Brazilian Oral Health Survey -SBBrazil 2010. The outcome studied was malocclusion, categorized as absent, set, severe and very severe. The independent variables were classifi ed as individual and contextual. Data were analyzed using a multilevel model with a 5% signifi cance level. RESULTS:It was found that the prevalence of severe and very severe malocclusion in 12-year-olds did not differ between the Brazilian regions, although variation between the cities was signifi cant (p < 0.001). Male children (p = 0.033), those on lower income (p = 0.051), those who had visited a dentist (p = 0.009), with lower levels of satisfaction with mouth and teeth (p < 0.001) and embarrassed to smile (p < 0.001) had more severe malocclusion. The characteristics of the cities also affected the severity of malocclusion; cities with more families on social benefi ts per 1,000 inhabitants, with lower scores on the health care system performance index and lower gross domestic product per capita were signifi cantly associated with malocclusion. CONCLUSION:Signifi cant associations between the presence and severity of malocclusion were observed at the individual and contextual level. The epidemiological profi le of oral health problems has changed, especially in children aged 12. In Brazil, tooth decay has shown a decrease in the DMFT index (decayed, missing and fi lled teeth) from 6.7 in 1986 to 2.07 in 2010 and, currently, a signifi cant number of those children are free of caries (43.5%). a Therefore, other problems related to the oral cavity have begun to receive attention, among them, occlusal changes stand out. DESCRIPTORS:14 Due to its high prevalence, the World Health Organization (WHO) now considers malocclusion to be the third largest public health problem in dentistry. 9,10 National data relating to malocclusion indicate a prevalence of 40.0% for the index age of 12 years. For severe, and very severe malocclusion, the prevalence is 10.4% and 7.1% respectively.a In many cases, malocclusion can impact on the quality of life of this part of the population. It can produce aesthetic deviations in the teeth and/or face and functional disturbances of occlusion, chewing, swallowing, pronunciation and breathing. It can also cause psychosocial disorders with potential repercussions on the self-esteem and interpersonal relationships of severely affected individuals. 5In the face of this reality, there is a need for a clearer picture in order to understand the disease process in relation to malocclusion. Thus, in addition to individual factors, other factors, called modifi ers or modulators (social, economic, cultural, ethnic/racial, psychological and behavioral factors), are related to the health of the population. Currently, these factors are known as social determinants of health.

INTRODUCTION: The aim of this study was to identify factors associated with the prevalence of anterior open bite among five-year-old Brazilian children. METHODS: A cross-sectional study was undertaken using data from the National Survey of Oral Health (SB Brazil 2010). The outcome variable was anterior open bite classified as present or absent. The independent variables were classified by individual, sociodemographic and clinical factors. Data were analyzed through bivariate and multivariate analysis using SPSS statistical software (version 18.0) with a 95% level of significance. RESULTS: The prevalence of anterior open bite was 12.1%. Multivariate analysis showed that preschool children living in Southern Brazil had an increased chance of 1.8 more times of having anterior open bite (CI 95%: 1.16 - 3.02). Children identified with alterations in overjet had 14.6 times greater chances of having anterior open bite (CI 95%: 8.98 - 24.03). CONCLUSION: There was a significant association between anterior open bite and the region of Brazil where the children lived, the presence of altered overjet and the prevalence of posterior crossbite.

Introdução: A promoção da saúde nas escolas envolve a educação em saúde, a criação de entornos saudáveis e a provisão de serviços de saúde. Este estudo objetivou realizar uma revisão crítica da literatura sobre a promoção da saúde nas escolas. Metodologia: Os critérios prévios de inclusão foram: artigos que relacionavam saúde escolar e promoção da saúde, sem limite temporal de publicação. Foram realizadas buscas eletrônicas nas principais bases de dados, entre janeiro e março de 2014. Foram utilizadas as seguintes palavras-chave e conjunto de palavras: promoção da saúde, saúde escolar, health promotion e school health [termo MeSH e termo palavra]. Também foram pesquisados estudos que preencheram os critérios de inclusão originados da lista de referências dos artigos selecionados. Revisão de literatura / Discussão: A saúde escolar avançou em sintonia com o conhecimento técnico-científico e com o desenvolvimento sócio-político, superando, de forma gradativa, o paradigma biomédico para a concepção da iniciativa das Escolas Promotoras de Saúde. No Brasil, foi instituído um novo programa para a saúde do escolar denominado Programa Saúde na Escola (PSE). O PSE se identifica como uma estratégia para a integração e articulação permanente entre as políticas e ações de educação e saúde. Considerações finais: Uma escola promotora de saúde caracteriza-se como uma escola que busca um estilo de vida, aprendizagem e trabalho que favoreça o desenvolvimento da saúde.