Abstract This study explores the senses and meanings attributed to dental work in the Brazilian National Health System (SUS) focusing on dentist-patient relations. A qualitative research was conducted with 20 dentists working in a medium-sized municipality in São Paulo, divided into three focus groups and asked the guiding question “What sense or meaning do you attribute to your work here in the city?” Data were audio-recorded, fully transcribed, and analyzed using thematic content analysis. Floating reading, categorization, and peer discussion of the findings were performed for the final validation, resulting in two categories: 1) Strangeness to patients’ needs and the subsequent medicalization of life, and 2) Power and consumption as meanings of practice. In this context, the dental practices showed the differences between patients’ needs and those considered relevant by dentists. It also showed the power imbalance between patients and professionals as a hindrance to patients’ autonomy. Such meanings seem to cause suffering to these professionals. In conclusion, reflections on health work are paramount to avoid suffering and understand that the practice of these dentists bears many senses and meanings.

Resumo Este artigo explora sentidos e significados do trabalho odontológico no SUS, no contexto da relação profissional-paciente. Pesquisa qualitativa com 20 cirurgiões-dentistas que atuavam em um município paulista de médio porte, abordada por meio de três grupos focais, com a pergunta disparadora “Qual é o sentido ou significado do seu trabalho, aqui na prefeitura, para você?”. O material foi áudio-gravado, transcrito na íntegra e analisado pelo método de análise de conteúdo temática. Procedemos a realização de leitura flutuante, categorização e discussão dos achados junto aos pares de pesquisadores para validação final. Como resultados, aponta-se a construção das categorias 1) Estranheza às necessidades percebidas pelos pacientes e a consequente medicalização da vida, e 2) Poder e consumo como significados da prática. O trabalho do cirurgião dentista, nesse contexto, evidenciou as diferenças entre as necessidades percebidas pelo paciente e aquelas que o dentista considera. Além disso, revelou o poder que emana da assimetria entre paciente e profissional como dificultador da produção de autonomia do paciente. Tais significações parecem trazer sofrimento para esses profissionais no seu trabalho. Concluiu-se que há necessidade de reflexão sobre o trabalho em saúde como forma de se evitar sofrimento, e que a prática desses dentistas é carregada de sentidos e significados.

Resumo Este artigo explora sentidos e significados do trabalho odontológico no SUS, no contexto da relação profissional-paciente. Pesquisa qualitativa com 20 cirurgiões-dentistas que atuavam em um município paulista de médio porte, abordada por meio de três grupos focais, com a pergunta disparadora “Qual é o sentido ou significado do seu trabalho, aqui na prefeitura, para você?”. O material foi áudio-gravado, transcrito na íntegra e analisado pelo método de análise de conteúdo temática. Procedemos a realização de leitura flutuante, categorização e discussão dos achados junto aos pares de pesquisadores para validação final. Como resultados, aponta-se a construção das categorias 1) Estranheza às necessidades percebidas pelos pacientes e a consequente medicalização da vida, e 2) Poder e consumo como significados da prática. O trabalho do cirurgião dentista, nesse contexto, evidenciou as diferenças entre as necessidades percebidas pelo paciente e aquelas que o dentista considera. Além disso, revelou o poder que emana da assimetria entre paciente e profissional como dificultador da produção de autonomia do paciente. Tais significações parecem trazer sofrimento para esses profissionais no seu trabalho. Concluiu-se que há necessidade de reflexão sobre o trabalho em saúde como forma de se evitar sofrimento, e que a prática desses dentistas é carregada de sentidos e significados.

Abstract This study explores the senses and meanings attributed to dental work in the Brazilian National Health System (SUS) focusing on dentist-patient relations. A qualitative research was conducted with 20 dentists working in a medium-sized municipality in São Paulo, divided into three focus groups and asked the guiding question “What sense or meaning do you attribute to your work here in the city?” Data were audio-recorded, fully transcribed, and analyzed using thematic content analysis. Floating reading, categorization, and peer discussion of the findings were performed for the final validation, resulting in two categories: 1) Strangeness to patients’ needs and the subsequent medicalization of life, and 2) Power and consumption as meanings of practice. In this context, the dental practices showed the differences between patients’ needs and those considered relevant by dentists. It also showed the power imbalance between patients and professionals as a hindrance to patients’ autonomy. Such meanings seem to cause suffering to these professionals. In conclusion, reflections on health work are paramount to avoid suffering and understand that the practice of these dentists bears many senses and meanings.

ABSTRACT: This study aimed to know perception of the marital subsystem (parents) and to understand the dynamics of the family system in offer of pacifiers. Ten couples, parents of children between 4 and 7 years old, were interviewed by means of a semi-structured script of questions about the offer of pacifiers for their children. Answers by qualitative method of content analysis, using predefined categories of the General Systems Theory (homeostasis, circularity, globality, non- summativity, morphogenesis and equifinality). Pacifier offer reestablished the Homeotasis related to adaptation of mother in postpartum period; in introduction of artificial nipples due to allergy to breast milk and to avoid thumb sucking. Circularity occurred in paternal support to stimulate breastfeeding and in offer of pacifier to reduce the dependence of baby regarding the mother. Globality occurred when offer of pacifier softened mastitis and colic of baby. Non-somivity was evidenced in the mother's attitude in controlling behavior of children with offer of pacifier. Morphogenesis predominated in influence of extern al systems (health, school, kinship, marketing and social media) on family decision to offer pacifiers. Offer of pacifiers interfe red in Equifinality, favoring the organization of family system in face of complications in breastfeeding. Offer of pacifier sought to meet emergency needs of baby, although there was a perception of consequences for child's health in long term. General Theory of Systems allowed verifying the dynamics of family system, which can be applied by health professionals in order to understand the factors involved in offer of pacifiers.

RESUMEN: Este estudio tuvo como objetivo conocer la percepción del subsistema conyugal (padres) y comprender la dinámica del sistema familiar en la oferta de chupetes. Se entrevistó a diez parejas, padres de niños entre 4 y 7 años, mediante un guión semiestructurado de preguntas sobre la oferta de chupetes para sus hijos. Respuestas por método cualitativo de análisis de contenido, utilizando categorías predefinidas de la Teoría General de Sistemas (homeostasis, circularidad, globalidad, no sumatividad, morfogénesis y equifinalidad). La oferta de chupete restableció la Homeotasis relacionada con la adaptación de la madre en el puerperio; en la introducción de pezones artificiales por alergia a la leche materna y para evitar chuparse el dedo. Ocurrió circularidad en el apoyo paterno para estimular el amamantamiento y en la oferta del chupete para reducir la dependencia del bebé con respecto a la madre. La globalidad ocurrió cuando la oferta del chupete suavizó la mastitis y el cólico del bebé. La no somividad se evidenció en la actitud de la madre en el control de la conducta de los niños con oferta de chupete. Predominó la morfogénesis en la influencia de los sistemas externos (salud, escuela, parentesco, marketing y redes sociales) en la decisión familiar de ofrecer chupetes. La oferta de chupetes interfirió en la Equifinalidad, favoreciendo la organización del sistema familiar frente a las complicaciones en la lactancia. La oferta del chupete buscó atender las necesidades de emergencia del bebé, aunque hubo una percepción de consecuencias para la salud del niño a largo plazo. La Teoría General de Sistemas permitió verificar la dinámica del sistema familiar, que puede ser aplicada por los profesionales de la salud para comprender los factores involucrados en la oferta de chupetes.

ABSTRACT: This study evaluated patients´ anxiety levels related to dental radiographic examinations in addition to dentists’ perception and management. Salivary alpha-amylase (sAA) activity of 47 patients was measured before and after exposure to radiographic examinations to assess their anxiety level and compared using Wilcoxon test. Mann-Whitney test assessed the sAA activity related to sex, type of examination, and previous experience with radiographic examinations. 50 dentists were interviewed using a semi-structured script containing open-ended questions perception on their patients' anxiety. Before the radiographic examination, sAA activity was significantly higher for women (p ≤0.05). SAA activity significantly increased after the examination for men, patients of both sexes with no previous experience and for those who underwent CBCT (p≤0.05). Anxiety was reported to be observed in adult patients’ speech and pediatric patients’ behavior. Dental radiographic examinations may be a source of anxiety for women before the examination. After the examination, men, patients with no previous experience, and those subjected to CBCT present higher anxiety levels. Dentists perceive anxiety in adult and pediatric patients differently.

RESUMEN: Este estudio evaluó los niveles de ansiedad en los pacientes relacionados con exámenes radiográficos dentales, además de la percepción y el manejo de los dentistas. Se midió la actividad de la alfa-amilasa salival (sAA) de 47 pacientes antes y después de la exposición a exámenes radiográficos para evaluar su nivel de ansiedad y se comparó mediante la prueba de Wilcoxon. La prueba de Mann-Whitney evaluó la actividad de la sAA relacionada con el sexo, el tipo de examen y la experiencia previa con exámenes radiográficos. Se entrevistó a 50 dentistas utilizando un guión semiestructurado de preguntas abiertas sobre la percepción de la ansiedad de sus pacientes. Antes del examen radiográfico, la actividad de la sAA era significativamente mayor para las mujeres (p≤0.05). La actividad de SAA aumentó significativamente después del examen para los hombres, pacientes de ambos sexos sin experiencia previa y para los que se sometieron a CBCT (p≤0.05). Se informó que se observa ansiedad en el habla de los pacientes adultos y en el comportamiento de los pacientes pediátricos. Los exámenes radiográficos dentales pueden ser una fuente de ansiedad para las mujeres antes del examen. Tras la exploración, los hombres, los pacientes sin experiencia previa y los sometidos a CBCT presentan niveles de ansiedad más elevados. Los dentistas perciben la ansiedad en los pacientes adultos y pacientes pediátricos de manera diferente.

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 Objetivo: Analisar a literatura científica referente ao desmame guiado pelo bebê (Baby-Led Weaning) por meio de revisão integrativa de literatura a fim de identificar riscos e benefícios. Fonte de dados: As bases de dados utilizadas foram: National Library of Medicine (MEDLINE), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), US National Library of Medicine (PubMed) e Biblioteca Virtual em Saúde (BVS); e a busca foi realizada em dezembro de 2017. Os critérios de inclusão estabelecidos foram publicações em inglês com o descritor “baby-led weaning” no título, resumo ou palavras-chave em artigos classificados como originais de natureza primária, disponibilizados online e na íntegra. Excluíram-se artigos de revisão, editoriais, cartas ao editor, comentários críticos e livros abordando o assunto, assim como artigos não disponíveis na íntegra e duplicatas. Síntese dos dados: Identificaram-se 106 artigos, dos quais 17 faziam parte do critério de seleção. O método Baby-Led Weaning teve associação significativa com a saciedade do bebê, início da alimentação complementar e adequação de ganho de peso. Já o engasgo e a ingestão de micronutrientes foram associados negativamente, contudo sem diferenças estatísticas. Conclusões: Apesar dos benefícios apontados, os riscos ainda merecem atenção por meio de pesquisas longitudinais controladas e randomizadas para fornecer mais segurança para a sua prática de forma exclusiva.

ABSTRACT Objective: To analyze the scientific literature on Baby-Led Weaning with an integrative literature review to identify risks and benefits. Data source: The databases used were: National Library of Medicine (MEDLINE), Latin American and Caribbean Literature in Health Sciences (LILACS – Literatura Latino-Americana e do Caribe em Ciências da Saúde), US National Library of Medicine (PubMed), and Virtual Health Library (BVS – Biblioteca Virtual em Saúde) in December 2017. The inclusion criteria established were publications in English with the descriptor “baby-led weaning” in the heading, abstract, or keywords, classified as original articles, of primary nature, and available online and in full. We excluded review articles, editorials, letters to the editor, critical commentaries, and books on the subject, as well as articles not available in full and duplicates. Data summary: We identified 106 articles, of which 17 met the selection criteria. The Baby-Led Weaning method was significantly associated with the baby’s satiety, the start of complementary feeding, and adequacy of weight gain. On the other hand, choking and the intake of micronutrients were negatively associated, however with no statistical differences. Conclusions: Despite the benefits found, the risks still deserve attention and should be investigated with longitudinal randomized controlled studies to ensure the safety of the method when practiced exclusively.

Resumo Avaliou-se a associação entre qualidade de vida, coesão familiar e fatores sociodemográficos de famílias beneficiárias do Programa Bolsa Família (PBF). Estudo transversal, analítico e de caráter exploratório com amostra representativa de 385 entrevistados. A variável dependente foi a qualidade de vida (WHOQOL-BREF), e as variáveis independentes quantificadas em características sociodemográficas, autopercepção sobre saúde, coesão e adaptabilidade familiar (FACES III). A melhor qualidade de vida associou-se com idade menor ou igual a 36 anos (OR = 2,15), maior nível educacional (OR = 1,54), boa/muito boa saúde (OR = 6,39), não ter problema de saúde atual (OR = 5,68), sem tratamento (OR = 1,76), moderada (OR = 3,39) e alta (OR = 3,66) coesão familiar e moderada adaptabilidade (OR = 2,23). Indivíduos provenientes de famílias com moderada e alta coesão familiar tiveram mais chance de ter uma melhor qualidade de vida do que aqueles vindos de famílias com baixa coesão. Os voluntários do sexo masculino tiveram 3,54 vezes mais chance de apresentar uma melhor qualidade de vida. Concluiu-se que níveis moderados e altos de coesão podem impactar positivamente uma melhor qualidade de vida das pessoas beneficiárias do PBF, indicando que as ações sociais devem buscar o fortalecimento dessa dinâmica.

Abstract We evaluated the association between quality of life, family cohesion and sociodemographic factors of beneficiary families of the BolsaFamília Program (PBF). This was an analytical, cross-sectional study with exploratory methodology. The sample was composed of 385 respondents. The dependent variable was the quality of life (WHOQOL-BREF), and the independent variables were sociodemographic characteristics, self-rated health, family cohesion and adaptability (FACES III). The best quality of life was associated with an age younger than or equal to 36 years (OR = 2.15), higher educational level (OR = 1.54), good/very good health (OR = 6.39), not having current health problem (OR = 5.68), no treatment (OR = 1.76), moderate (OR = 3.39) and high (OR = 3.66) family cohesion and moderate adaptability (OR = 2.23). Individuals from families with moderate and high family cohesion were more likely to have a better quality of life than those from families with low cohesion. The male volunteers were 3.54 times more likely to have a better quality of life. It was concluded that moderate and high levels of cohesion may impact positively to the quality of life of persons receiving the PBF, indicating that social programs should seek to strengthen these dynamics.

Abstract It has been postulated that oral health-related quality of life (OHRQoL) may be affected by the sense of coherence (SOC), but there are no epidemiological studies investigating this association in Brazilian adults. The present study was conducted among adults of a mid-sized Brazilian city, with the aim of looking into this association. The probability sampling consisted of 342 adults aged 35-44 years old, from a mid-sized Brazilian city, who were examined at their homes for caries (Decayed, Missing and Filled Teeth [DMFT] Index) and periodontal disease (Community Periodontal Index - CPI), according to WHO criteria. The questionnaire applied included demographic factors, socioeconomic information, use of dental services, behavior, SOC and the Oral Health Impact Profile (OHIP). The OHIP outcome, measured by prevalence of the impact, was analyzed by binary logistic regression using a hierarchical approach, a conceptual model, and a 5% significance level. A total of 67.9% of the respondents had one or more impacts on OHRQoL, and 54.4% showed a high SOC. The impact on OHRQoL was more prevalent in adults who had a manual occupation (PR = 2.47, 95%CI 1.24–4.93), those who perceived the need for dental treatment (PR = 2.93, 95%CI 1.67–5.14), and those who had untreated caries (PR = 1.93, 95%CI 1.07–3.47). Those with a low SOC had a twofold higher prevalence of impact on OHRQoL (PR = 2.19, 95%CI 1.29–3.71). This impact on OHRQoL was associated with a low SOC, even after adjusted by socioeconomic, behavioral and clinical factors. Future studies should consider the SOC in determining the oral health impact on quality of life.

Introdução: A apuração de como as Assistências Farmacêuticas Básicas (AFB) municipais estão estruturadas permite o delineamento do diagnóstico situacional e visualização de possíveis implicações em parte essencial do Sistema Único de Saúde. Métodos: Avaliamos as AFB de todos os municípios que compõem a Comissão Intergestores Regional de Saúde de Ourinhos-SP (CIR-Ourinhos- SP), por meio de indicadores de estrutura, processo e resultado, e propôs-se, de forma compartilhada, ações para qualificar a prática. Foram realizadas observações diretas em medicamentos, cadastros, documentos, entrevistas com farmacêuticos, visitas às unidades de saúde (US), perfazendo 12 municípios, 41 US e 03 Centrais de Abastecimento Farmacêutico (CAF). Resultados: Na oficina temática realizada com os representantes municipais verificou- se, entre outras coisas, que 68,33% das US e 70% das CAF, cumpriam as boas práticas de armazenamento. Foi encontrada a média de 0,85 farmacêutico por unidade e presença de 88,91% de medicamentos marcadores. As propostas da Oficina foram encaminhadas aos gestores e farmacêuticos responsáveis pelas AFB dos 12 municípios. Conclusões: A maioria dos indicadores ficou abaixo dos padrões estabelecidos, demonstrando a necessidade de adequações na infraestrutura e de oferta de capacitações para as os profissionais.

Introduction: Determining how primary pharmaceutical assistance is structured allows us to establish situational diagnoses and to visualize possible implications for an essential part of the Brazilian Unified Health System. - Methods: We evaluated pharmaceutical services of all municipalities that compose the Regional Inter-Agency Committee on Health of Ourinhos-São Paulo (CIR-Ourinhos-SP) through structure, process, and outcome indicators, and, in a shared way, we proposed actions to qualify the practice. We conducted direct observations of drugs, records, documents, interviews with pharmacists, and visits to health care centers, totaling 12 municipalities, 41 health care centers, and 3 pharmaceutical supply services. - Results: In the thematic workshop carried out with municipal representatives, we found that 68.33% of health care centers and 70% of pharmaceutical supply services met good storage practices. We verified an average of 0.85 pharmacists per unit and the presence of 88.91% of marker drugs. Workshop proposals were sent to managers and pharmacists responsible for pharmaceutical assistance of 12 municipalities. - Conclusions: Most indicators were below the established standards, demonstrating the need for adjustments in the infrastructure and provision of training for professionals

Resumo Avaliou-se a associação entre qualidade de vida, coesão familiar e fatores sociodemográficos de famílias beneficiárias do Programa Bolsa Família (PBF). Estudo transversal, analítico e de caráter exploratório com amostra representativa de 385 entrevistados. A variável dependente foi a qualidade de vida (WHOQOL-BREF), e as variáveis independentes quantificadas em características sociodemográficas, autopercepção sobre saúde, coesão e adaptabilidade familiar (FACES III). A melhor qualidade de vida associou-se com idade menor ou igual a 36 anos (OR = 2,15), maior nível educacional (OR = 1,54), boa/muito boa saúde (OR = 6,39), não ter problema de saúde atual (OR = 5,68), sem tratamento (OR = 1,76), moderada (OR = 3,39) e alta (OR = 3,66) coesão familiar e moderada adaptabilidade (OR = 2,23). Indivíduos provenientes de famílias com moderada e alta coesão familiar tiveram mais chance de ter uma melhor qualidade de vida do que aqueles vindos de famílias com baixa coesão. Os voluntários do sexo masculino tiveram 3,54 vezes mais chance de apresentar uma melhor qualidade de vida. Concluiu-se que níveis moderados e altos de coesão podem impactar positivamente uma melhor qualidade de vida das pessoas beneficiárias do PBF, indicando que as ações sociais devem buscar o fortalecimento dessa dinâmica.

Abstract We evaluated the association between quality of life, family cohesion and sociodemographic factors of beneficiary families of the BolsaFamília Program (PBF). This was an analytical, cross-sectional study with exploratory methodology. The sample was composed of 385 respondents. The dependent variable was the quality of life (WHOQOL-BREF), and the independent variables were sociodemographic characteristics, self-rated health, family cohesion and adaptability (FACES III). The best quality of life was associated with an age younger than or equal to 36 years (OR = 2.15), higher educational level (OR = 1.54), good/very good health (OR = 6.39), not having current health problem (OR = 5.68), no treatment (OR = 1.76), moderate (OR = 3.39) and high (OR = 3.66) family cohesion and moderate adaptability (OR = 2.23). Individuals from families with moderate and high family cohesion were more likely to have a better quality of life than those from families with low cohesion. The male volunteers were 3.54 times more likely to have a better quality of life. It was concluded that moderate and high levels of cohesion may impact positively to the quality of life of persons receiving the PBF, indicating that social programs should seek to strengthen these dynamics.

Resumo Introdução Os índices de aleitamento materno no Brasil permanecem muito abaixo dos considerados ideais, fazendo-se necessário o entendimento das variáveis envolvidas na fragmentação do aleitamento ao longo dos meses de vida da criança. Objetivo Objetivou-se, neste estudo, verificar a associação entre o tipo de aleitamento no momento da alta hospitalar do recém-nascido e a prática da amamentação aos seis meses de vida. Método Estudo transversal, com dados coletados do prontuário clínico de 301 crianças participantes de um programa de incentivo ao aleitamento materno. Foram considerados os fatores de risco e de proteção ao aleitamento, tais como: idade dos pais, presença do companheiro, paridade, renda familiar, permanência em alojamento conjunto, tempo decorrido do nascimento até a primeira mamada, tempo de hospitalização, tipo de amamentação na alta hospitalar e uso de chupeta ao longo dos seis meses de vida. Resultados Os resultados mostraram haver associação significativa entre aleitamento materno exclusivo na alta hospitalar e aos seis meses de idade (p=0,0205). Conclusão A observação desses dados permite concluir que é importante que, ao deixar a maternidade, o bebê esteja em amamentação exclusiva, pois, dessa forma, terá 2,5 vezes mais chances de manter esse tipo de aleitamento até os seis meses de vida.

Abstract Introduction Breastfeeding rates in Brazil remain far below those considered ideal, making it necessary understanding the variables involved in the fragmentation of this process over the months of a child’s life. Objective The objective of this study was to investigate the association between type of breastfeeding of newborns at hospital discharge and at six months of age. Method A cross-sectional study with data collected from the medical records of 301 children participating in a program to encourage exclusive breastfeeding. The study considered risk and protection factors to breastfeeding such as age of parents, presence of mate, parity, family income, stay in room, time elapsed from birth to first breastfeeding, hospitalization time, type of breastfeeding at hospital discharge, and use of pacifier until the age of six months. Results The results revealed significant correlation between exclusive breastfeeding at hospital discharge and at six months of age (p=0.0205). Conclusion Observation of data enabled the following conclusion: it is important that newborns undergo exclusive breastfeeding after hospital discharge because, this way, they will be 2.5 times more likely to maintain this type of feeding until the age of six months.

Resumo Este estudo objetivou avaliar a associação entre qualidade de vida e variáveis clínicas e sociodemográficas em pacientes diabéticos tipo 2, após iniciarem tratamento na Atenção Primária e Especializada. Trata-se de um estudo transversal analítico com amostra de pacientes diabéticos provenientes da Atenção Primária (n = 385) e Especializada (n = 385). A variável dependente, qualidade de vida, foi avaliada pelo Diabetes Quality of Life Measure – Brasil. Foram coletados dados clínicos e sociodemográficos. Análise bivariada pelo teste qui-quadrado testou a associação entre a variável dependente com as independentes. Em seguida, realizou-se análise de regressão logística múltipla. Na Atenção Especializada, os indivíduos que realizaram atividade física tiveram menos chance de ter pior qualidade de vida e aqueles com menor tempo de diagnóstico apresentaram mais chance de pior qualidade de vida. Na Atenção Primária, os que realizaram dieta e que apresentaram hemoglobina glicada ≤ 7% tiveram menos chance de ter pior qualidade de vida. Já os do sexo feminino apresentaram mais chance de pior qualidade de vida do que os do masculino. Conclui-se que com exceção do tempo de diagnóstico e sexo, as demais variáveis que influenciaram na qualidade de vida dos diabéticos foram fatores modificáveis.

Abstract This study aimed to assess the association between quality of life and clinical and sociodemographic variables in type 2 diabetes patients, after they had started treatment in Primary and Specialized Health Care. This is an analytical cross-sectional study with a sampling of diabetic patients from Primary (n = 385) and Specialized (n = 385) Health Care. The dependent variable, quality of life, was evaluated by the Diabetes Quality of Life Measure - Brazil. Clinical and sociodemographic data were collected. Bivariate analysis by chi square test tested the association between the dependent variable with the independent ones. Next, we performed an analysis of multiple logistic regression. In Specialized Health Care, individuals who practice physical activity had less chance of having worse quality of life and those with less time of diagnosis presented higher chance of worse quality of life. In Primary Health Care, those who performed diets and presented glycated hemoglobin ≤ 7% had less chance of having worse quality of life. Women presented higher chances of worse quality of life than men. We concluded that with exception to the time of diagnosis and sex, other variables that influenced quality of life of diabetics were modifiable factors (glycated hemoglobin, alimentary diet and physical activity).

Resumo Este estudo objetivou avaliar a associação entre qualidade de vida e variáveis clínicas e sociodemográficas em pacientes diabéticos tipo 2, após iniciarem tratamento na Atenção Primária e Especializada. Trata-se de um estudo transversal analítico com amostra de pacientes diabéticos provenientes da Atenção Primária (n = 385) e Especializada (n = 385). A variável dependente, qualidade de vida, foi avaliada pelo Diabetes Quality of Life Measure – Brasil. Foram coletados dados clínicos e sociodemográficos. Análise bivariada pelo teste qui-quadrado testou a associação entre a variável dependente com as independentes. Em seguida, realizou-se análise de regressão logística múltipla. Na Atenção Especializada, os indivíduos que realizaram atividade física tiveram menos chance de ter pior qualidade de vida e aqueles com menor tempo de diagnóstico apresentaram mais chance de pior qualidade de vida. Na Atenção Primária, os que realizaram dieta e que apresentaram hemoglobina glicada ≤ 7% tiveram menos chance de ter pior qualidade de vida. Já os do sexo feminino apresentaram mais chance de pior qualidade de vida do que os do masculino. Conclui-se que com exceção do tempo de diagnóstico e sexo, as demais variáveis que influenciaram na qualidade de vida dos diabéticos foram fatores modificáveis.

Abstract This study aimed to assess the association between quality of life and clinical and sociodemographic variables in type 2 diabetes patients, after they had started treatment in Primary and Specialized Health Care. This is an analytical cross-sectional study with a sampling of diabetic patients from Primary (n = 385) and Specialized (n = 385) Health Care. The dependent variable, quality of life, was evaluated by the Diabetes Quality of Life Measure - Brazil. Clinical and sociodemographic data were collected. Bivariate analysis by chi square test tested the association between the dependent variable with the independent ones. Next, we performed an analysis of multiple logistic regression. In Specialized Health Care, individuals who practice physical activity had less chance of having worse quality of life and those with less time of diagnosis presented higher chance of worse quality of life. In Primary Health Care, those who performed diets and presented glycated hemoglobin ≤ 7% had less chance of having worse quality of life. Women presented higher chances of worse quality of life than men. We concluded that with exception to the time of diagnosis and sex, other variables that influenced quality of life of diabetics were modifiable factors (glycated hemoglobin, alimentary diet and physical activity).

Resumo Introdução A perda dentária é considerada um evento grave na vida dos pacientes e pode levá-los à reclusão social. A reabilitação por meio de próteses pode contribuir para a melhora da autoimagem de edêntulos totais. Objetivo Este estudo teve como objetivo conhecer os fatores associados aos sentimentos decorrentes da perda de dentes e às expectativas quanto à nova prótese. Métodos Estudo transversal analítico com 119 pacientes edêntulos totais (faixa etária entre 29 e 87 anos) em tratamento para confecção de prótese em uma clínica-escola. Resultados Os pacientes que relataram ter perdido seus dentes devido ao medo de submeter-se ao tratamento ou a dificuldades de acesso foram os que mais sofreram com a perda dentária (OR=2,57). Os pacientes mais jovens (OR=3,33) e do sexo feminino (OR=3,89) foram aqueles que demonstraram mais expectativas em relação à prótese que estava sendo confeccionada. Conclusão As mulheres e as pessoas mais jovens são aquelas que manifestaram mais raiva ou tristeza pela perda dentária e que possuíam expectativas estéticas e de socialização em relação à nova prótese.

Abstract Introduction The tooth loss is considered a serious event on the life of patients and it may take them to social withdrawal. The rehabilitation through prosthetics can improve self-image of total edentulous. Objective This study aimed to assess factors associated with feelings related to tooth loss and the expectations regarding the new prosthesis. Methods A cross-sectional study with 119 total edentulous patients (age range: 29-87 years) undergoing prostheses treatment in a University Clinic. Results The patients who reported having lost their teeth due to fear of undergoing treatment or access difficulties were the ones who suffered most from tooth loss (OR = 2.57). Younger patients (OR = 3.33) and female (OR = 3.89) were those that showed more expectations for the prosthesis that was being made. Conclusion Women and young people are those who express more anger or sadness due to tooth loss and have aesthetic and socialization expectations for the new prosthesis.

Resumo Introdução Os gestores municipais da saúde devem responder às demandas de suas equipes e dos pacientes do Sistema Único de Saúde, enfrentando cotidianamente situações potencialmente estressoras. A sobrecarga no trabalho pode levar à exaustão física e mental, com esgotamento dos recursos emocionais, e desencadear a Síndrome de Burnout (SB), cujas consequências podem atingir o serviço gerenciado, uma vez que, ao desempenhar essa atividade laboral, tomam-se decisões determinantes nas ações em saúde que afetam muitas pessoas. Este estudo verificou a presença da SB nos gestores municipais de saúde do Estado de São Paulo. Métodos Estudo do tipo transversal no qual foram coletados dados socioeconômicos e demográficos. Os níveis de SB foram avaliados pela aplicação do Cuestionario para la Evaluación del Síndrome de Quemarse por el Trabajo (CESQT). A análise descritiva foi realizada por meio do cálculo de frequências. Resultados Verificou-se baixa prevalência de SB entre os 199 gestores participantes do estudo. Porém houve casos indicativos da presença da SB, inclusive com características de Perfil 2. Conclusão Esses achados evidenciam que essa classe de profissionais necessita de atenção e cuidados para prevenção e controle das consequências da SB, a fim de evitar que pessoas doentes gerenciem serviços de saúde.

Abstract Background Municipal health managers must respond to the demands of their staff and Unified Health System´s patients, facing daily potentially stressful situations. The work overload can lead to physical and mental exhaustion, with depletion of emotional resources, and trigger the Burnout Syndrome (BS) with consequences that can affect the service, as the managing activity takes major decisions on health actions that affect many people. This study verified the presence of BS in the municipal health managers in the state of São Paulo. Methods Cross-sectional study. Demographic and socioeconomic data were collected and BS levels were evaluated by application of the Cuestionario para La Evalución Del Síndrome de Quermarse por El Trabajo (CESQT). The descriptive analysis was performed using the frequency estimation. Results We verified a low prevalence of BS among 199 participants. However, some cases, including profile 2 features, indicated the presence of BS. Conclusion These findings show that this is a professional class in need of attention and care to prevent and control the consequences of BS, in order to prevent sickness in health services managers.