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Search Results: 1 - 10 of 84620 matches for " José Leopoldo Ferreira;Narvai "
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Políticas de saúde bucal no Brasil e seu impacto sobre as desigualdades em saúde
Antunes,José Leopoldo Ferreira; Narvai,Paulo Capel;
Revista de Saúde Pública , 2010, DOI: 10.1590/S0034-89102010005000002
Abstract: this text systematizes available knowledge about the main dental health policies in brazil in regards to their current degree of implementation and their impact on health inequalities. although the fluoridation of publicly distributed water is legally mandated in brazil, its implementation has been subject to marked regional inequalities. data are presented about the extent of implementation for the intervention, and studies are reviewed that evaluate the intervention's impact upon increasing inequality in the experience of dental caries. the provision of public dental services, which expanded considerably after the implementation of the national unified health care system, is also discussed in relation to service provision and its impact on reducing inequality in access to dental treatment. the discussion of the differential effect of these interventions allowed for the proposal of targeted strategies (directing fluoridation to areas of greater need), aiming to reduce inequalities in the experience of dental caries in brazil.
Perda dentária precoce em adultos de 35 a 44 anos de idade: estado de S?o Paulo, Brasil, 1998
Fraz?o, Paulo;Antunes, José Leopoldo Ferreira;Narvai, Paulo Capel;
Revista Brasileira de Epidemiologia , 2003, DOI: 10.1590/S1415-790X2003000100007
Abstract: secondary data on the oral health status of adults aged 35 - 44 were analysed in order to estimate the prevalence of caries and early tooth loss. a non-probabilistic sample of 5,777 teachers and workers of public and private schools randomly selected in 131 cities of the state of sao paulo were gathered for the oral examination. the assessment of caries followed the international methodological standard criteria recomended by the world health organization (1997). the dmft index, corresponding to the number of decayed, missing and filled teeth, and the proportion of subjects with at least 20 remaining teeth were analyzed and classified by age, sex and ethnic groups, access to fluoridated water supply, urban or rural school, and city population. the 1991 census - the most recent source of general information of the population then available - supplied information on socioeconomic status at the municipal level. spatial data analysis was used in order to appraise the association between oral health status and socioeconomic indicators. the dmft of adults scored 22,39 (6,24), half of this value associated with missing teeth. increased rates of early tooth loss were observed for older subjects, for those working in rural settings, for blacks, for towns with reduced population size, and those with no fluoridated water supply. municipal socioeconomic indicators correlated with the proportion of subjects with at least 20 remaining teeth. these results may help policy makers to formulate public polices on oral health promotion.
Precis?o e validade de levantamentos epidemiológicos em saúde bucal: cárie dentária na Cidade de S?o Paulo, 2002
Frias, Antonio Carlos;Antunes, José Leopoldo Ferreira;Narvai, Paulo Capel;
Revista Brasileira de Epidemiologia , 2004, DOI: 10.1590/S1415-790X2004000200004
Abstract: the present study aims at describing the assessment of the reliability and accuracy of a survey of dental caries performed in the city of s?o paulo in 2002, as part of the sb2000 project of the ministry of health. the appraisal of indexes used methodology internationally standardized by the world health organization. during the training of examiners participating in the survey, an exercise of calibration was conducted for the gauging of inter-observer agreement, which involved nine dental surgeons and two groups of 20 schoolchildren. the coordinator of the survey was assigned as the gold standard for the validation of the oral examination records in the calibration process. furthermore, during the gathering of data, 58 schoolchildren were reexamined by the same professionals, for the assessment of intra-observer agreement. we calculated high synthetic indicators of reliability for the survey: respectively 99.83% and 96.45% for the percentage of overall intra- and inter-observer agreement, and 0.996 and 0.943 for the corresponding values of kappa statistics. the validity of the study was also evaluated positively, with high global indicators of sensitivity (0.972) and specificity (0.978). the evaluation of reliability and accuracy for each observer produced high and satisfactory indicators. the description of the procedures chosen for the assessment of reliability and accuracy, as well as the presentation of results, can provide methodological indications for subsequent studies of dental caries distribution.
Cárie dentária e condi??es sócio-econ?micas no Estado do Paraná, Brasil, 1996
Baldani, Márcia Helena;Narvai, Paulo Capel;Antunes, José Leopoldo Ferreira;
Cadernos de Saúde Pública , 2002, DOI: 10.1590/S0102-311X2002000300024
Abstract: the aim of this research was to determine the correlation between dental caries and socioeconomic conditions in the state of paraná, brazil. caries prevalence was estimated for each city in the state by gathering data on the dmft index (in 12-year-old schoolchildren) supplied by the state health department. official socioeconomic data for the municipalities were also presented. ordinary least squares regression analysis was performed, and significant correlation coefficients were observed between the dental caries index and various social development indicators. maps highlighting the overlapping areas with poor outcomes for most of these variables were presented. the results showed a significantly lower dmft index in cities with fluoridated water supply and a negative correlation between the caries index and the proportion of households with running water in cities with fluoridated water supply. this observation highlights the importance of fluoridated drinking water for the prevention of dental caries and as a measure to reduce the impact of socioeconomic inequalities on the prevalence of tooth decay.
Determinantes individuais e contextuais da prevalência de cárie dentária n?o tratada no Brasil
Frias,Ant?nio Carlos; Antunes,José Leopoldo Ferreira; Junqueira,Simone Rennó; Narvai,Paulo Capel;
Revista Panamericana de Salud Pública , 2007, DOI: 10.1590/S1020-49892007000900008
Abstract: objective: to describe the prevalence of untreated caries among adolescents in brazil and to analyze the association between caries and individual and contextual factors in the municipalities where these adolescents live. methods: a ministry of health database (projeto sb-brasil) provided health records on 16 833 adolescents from 15-19 years of age. the study variable used was the presence of at least one permanent tooth having been lost to caries. the individual variables considered were: sex, ethnic group, living in an urban versus a rural area, and being a student or not. contextual variables related to the municipality were: municipal human development index (mhdi), proportion of households connected to the water system, and water fluoridation for 5 years or more. multilevel logistic regression analysis was carried out to adjust the outcome to the individual and contextual variables. results: individual determinants related to a higher probability of untreated caries were: the ethnic group described as "black or brown," (adjusted odds ratio, oradjust = 1.79; 1.68 to 1.92); and living in a rural area (oradjust = 1.31; 1.19 to 1.45). being a student was identified as a protective factor (oradjust = 0.67; 0.62 to 0.73). secondary variables identified as contextual determinants of caries were mhdi (adjusted coefficient b = -0.213), water fluoridation (b = -0.201), and households connected to the water system (b = -0.197). conclusions: the results show inequalities in the distribution of health services in the various brazilian regions, and suggest that inequalities may also be present in the effectiveness of the services provided. policies to increase access to fluoride-treated water and school enrollment may contribute to preventing caries in adolescents.
Cárie dentária e condi es sócio-econ micas no Estado do Paraná, Brasil, 1996
Baldani Márcia Helena,Narvai Paulo Capel,Antunes José Leopoldo Ferreira
Cadernos de Saúde Pública , 2002,
Abstract: O presente estudo foi conduzido com o objetivo de analisar as rela es entre cárie dentária e fatores sócio-econ micos no Estado do Paraná, Brasil. Foram reunidas informa es sobre a prevalência de cárie dentária (CPO-D aos 12 anos) para os municípios do Estado, conforme dados oficiais disponibilizados pela Secretaria de Estado da Saúde. P de-se observar correla o significante entre o índice de cárie dentária nos municípios e vários indicadores de desenvolvimento social, através da análise de regress o linear simples. A rela o visual entre as cidades com piores figuras de CPO-D e indicadores sociais, foi apresentada em mapas através do georreferenciamento de dados. Observou-se CPO-D médio menos elevado nos municípios cujos reservatórios de água foram fluorados. Observou-se também, correla o negativa entre o índice de cárie dentária e a propor o de domicílios ligados à rede de abastecimento de água, nos municípios com água fluorada. Nesse sentido, sublinha-se a importancia desse benefício, n o só como recurso para a redu o dos níveis de cáries, como também para atenuar o impacto das desigualdades sócio-econ micas sobre a prevalência de cárie dentária.
Custo da fluoreta??o das águas de abastecimento público, estudo de caso - Município de S?o Paulo, Brasil, período de 1985-2003
Frias, Antonio Carlos;Narvai, Paulo Capel;Araújo, Maria Ercilia de;Zilbovicius, Celso;Antunes, José Leopoldo Ferreira;
Cadernos de Saúde Pública , 2006, DOI: 10.1590/S0102-311X2006000600013
Abstract: the aim of this study was to estimate the cost of fluoridating the public water supply in the city of s?o paulo, brazil, from 1985 to 2003. cost calculation for fluoridation of the public water supply used the following: capital cost of initial installation, chemical product (hydrofluosilicic acid), system's operational cost (maintenance, electricity, and human resources), and monitoring fluoride levels. fluoridation was effective, since there was a decrease of 73% in dental caries in 12-year-olds - mean dmf was 6.47 (6.12-6.82) in 1986, having decreased to 1.75 (1.48-2.92) in 2002. in this age group, 40% of children presented dmf = 0 in 2002. average cost per inhabitant/year for 2003 was r$ 0.08 (us$ 0.03). the accumulated cost for 18 years of implementation and maintenance of the fluoridation system was r$ 1.44 (us$ 0.97) per capita.
The association between socioeconomic development at the town level and the distribution of dental caries in Brazilian children
Peres,Marco Aurélio; Peres,Karen Glazer; Antunes,José Leopoldo Ferreira; Junqueira,Simone Rennó; Fraz?o,Paulo; Narvai,Paulo Capel;
Revista Panamericana de Salud Pública , 2003, DOI: 10.1590/S1020-49892003000800001
Abstract: objective: to investigate the association between dental caries among children in the state of s?o paulo, brazil, and town-level indices of socioeconomic development. methods: we examined 15 385 oral-examination records from children aged 5 or 6 years old from 129 towns and cities in the state of s?o paulo. we studied two outcomes: (1) the mean number of decayed, missing, and filled deciduous teeth (dmft index) and (2) the care index, which is the proportion of decayed teeth that have already been filled. the explanatory variables were the child development index, human development index, illiteracy rate among subjects older than 20 years, household income, gini coefficient, insufficient income, fluoridated water supply, number of dentists per 10 000 inhabitants, number of dentists in the public service per 10 000 inhabitants, and number of weekly hours of dentist work in the public service per 10 000 inhabitants. multiple linear regression models were fitted to the two outcome variables (dmft index and care index). results: the multiple linear regression analysis showed that a higher dmft index was associated with a low child development index, a high illiteracy rate, and an unfluoridated water supply. the child development index was significantly associated with the care index, and the number of dentists in the public service per 10 000 inhabitants showed borderline statistical significance. conclusions: our results indicate that town-level indices of socioeconomic status are significantly correlated with caries indices. our results also emphasize the beneficial effect that fluoridating water has on reducing the prevalence of dental caries and the fact that strategies for treating and preventing oral diseases should be emphasized within the context of overall health promotion for children.
Validade científica de conhecimento epidemiológico gerado com base no estudo Saúde Bucal Brasil 2003
Narvai, Paulo Capel;Antunes, José Leopoldo Ferreira;Moysés, Samuel Jorge;Fraz?o, Paulo;Peres, Marco Aurélio;Peres, Karen Glazer;Sousa, Maria da Luz Rosário de;Roncalli, Angelo Giuseppe;
Cadernos de Saúde Pública , 2010, DOI: 10.1590/S0102-311X2010000400002
Abstract: indicators and analyses that used the database from sb brazil 2003 (the most recent nationwide oral health survey) have been criticized as unreliable due to sampling problems. the current study countered that this critique was based solely on statistical concepts, unsupported by empirical evidence. the critique's essentially epistemic approach leads to peremptory reductionism that denies other forms of knowledge and fails to recognize the multidisciplinary nature of epidemiology. the current study retrieves information on the implementation of the oral health survey and its impact on knowledge output in the field. the article draws an analogy between science and art, demonstrating the multifaceted images obtained by both. thus, recognition of validity requires a full grasp of the field and appropriate use of value criteria. the current article concludes that use of the sb brazil 2003 database is a reliable and relevant application of epidemiology to oral health.
"Grow and multiply": social development, birth rates and demographic transition in the Municipality of S?o Paulo, Brazil, time-series for 1901-94
Antunes, José Leopoldo Ferreira;
Revista Brasileira de Epidemiologia , 1998, DOI: 10.1590/S1415-790X1998000100007
Abstract: this study reports the construction of time-series related to standardized mortality rate, proportional mortality ratio of swaroop and uemura, infant mortality rate, fetal death rate, expectation of life at birth and birth rate for the city of s?o paulo, sp, brazil, from 1901 to 1994. in order to determine the structural variation of these measures, the model, forecast and correlation of these series were submitted to statistical analysis. the results obtained were compared to the historical analysis of the major socioe-conomic phenomena during this period in an effort to explain populational movements in the city, with emphasis on the slow and late nature of the process of demographic transition in the city. it was concluded that time-series analysis for demographic measures is efficient in many ways: by allowing the application of statistical methodology to the human sciences, by passing the difficulties inherent in the characteristics of these values (serial correlation, heteroscedasticity, multicollinearity and non-normality of forecast error distribution), by integrating quantitative analysis with the historical interpretation of the phenomena approached, by projecting estimates of future trends on the basis of the behavior of the variables analyzed, and by systematizing the methodology for application in future studies of social research.
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