Social capital and self-rated health among adolescents in Brazil: an exploratory study

<p>Abstract</p> <p>Background</p> <p>Social capital may influence health and the patterns of association differ according its dimension such as cognitive, behavioral, bridging or bonding. There is a few numbers of studies in Latin America which comprise these aspects of social capital and health. The aim of this study was to examine the association between social capital and self-rated health among youth, and distinguish between the different forms of social capital - cognitive versus behavioral, and bonding versus bridging.</p> <p>Findings</p> <p>A cross-sectional study was conducted in 2009 among working adolescents supported by a Brazilian NGO. The sample comprised 363 individuals and data were collected using a validated structured questionnaire. The outcome, self-rated health, was measured as a dichotomous variable (poor/good health) and fourteen social capital indicators were investigated (cognitive, behavioral and bonding/bridging). Data were analyzed using multivariate logistic regression. Cognitive (social support and trust), behavioral (civic participation) and bridging social capital were associated with good self-rated health after adjustment of all the other social capital indicators and confounders (sex, age, skin color and educational background).</p> <p>Conclusions</p> <p>Social capital was associated with self-rated health and the patterns of association differed according its specific dimensions. Cognitive, behavioral and bridging social capitals were protective for adolescents health living in a developing country context..</p

Association between Binge Drinking, Type of Friends and Gender: A Cross-sectional Study among Brazilian Adolescents

Background: Hazardous drinking among adolescents is a major public health concern. The purpose of this study was to examine the prevalence of binge drinking/alcohol consumption and its association with different types of friendship networks, gender and socioeconomic status among students in Belo Horizonte, Minas Gerais, Brazil. Methods We conducted a cross-sectional study on a representative random sample of 891 adolescents (41% male, aged 15–19 years) from public and private schools in 2009–2010. Information on friendship networks and binge drinking was collected using two validated self-administered questionnaires: the Integrated Questionnaire for the Measurement of Social Capital and the first 3 items in the Alcohol Use Disorders Identification Test (AUDIT C). We used the area-based Social Vulnerability Index (SVI), mother and father’s educational background, and the type of school to assess socioeconomic status. The chi-squared test was used to examine the associations between sample characteristics or the type of friends and binge drinking (p-values <0.05 were considered statistically significant). Ordinal logistic regression was used to estimate the association between binge drinking and the independent variables. Results: A total of 321 (36%) adolescents reported binge drinking (5 or more drinks in one occasion), and among them, 233 (26.2%) adolescents reported binge drinking less than monthly to monthly, and 88 (9.9%) weekly to daily. Binge drinking was associated with being male (OR = 1.52, 95% CI 1.01–2.28) and with living in a low vulnerability area (having the best housing conditions, schooling, income, jobs, legal assistance and health) (OR = 1.66, 95% CI 1.05–2.62). Students who reported that their closest friends were from school (as opposed to friends from church) had an increased risk of binge drinking (OR = 3.55, 95% CI 1.91–5.87). In analyses stratified by gender, the association was significant only among the female students. Conclusions: The prevalence of binge drinking was high in this sample of Brazilian adolescents, and gender, low social vulnerability and friendship network were associated with binge drinking

Accuracy of the Simplified Thylstrup & Fejerskov Index in Rural Communities with Endemic Fluorosis

The aim of the present study was to compare the values of the Thylstrup & Fejerskov Index (TF index) for the determination of the prevalence of dental fluorosis using either all teeth (gold standard) or six upper anterior teeth (simplified TF index). The sample was made up of 396 individuals aged six to 22 years from three Brazilian cities with endemic fluorosis caused by the ingestion of water with high fluoride concentration. The prevalence of dental fluorosis was evaluated by a single trained examiner with excellent intraexaminer agreement (kappa = 0.95). Intraexaminer reproducibilities were calculated at tooth level. Sensitivity, specificity, positive and negative predictive values of the simplified TF compared to gold standard were 90.6 (95%CI: 86.6 to 93.6), 100 (95%CI: 95.3 to 100), 100 (95%CI: 98.3 to 100) and 77.5 (95%CI: 69.8 to 83.5), respectively. The ROC value was 0.953 (95%CI: 0.933 to 0.973). The simplified TF index proved suitable for determining the prevalence of dental fluorosis in regions with endemic fluorosis caused by the ingestion of water with high concentrations of fluoride

“When a Tihik drinks kaxmuk he neither has a father, nor a mother, or a brother” : perceptions of Maxakali on the effects of sugarcane liquor consumption

Este artigo explora um dos aspectos mais interessantes e menos estudados no Brasil: as consequências das experiências complexas e contraditórias da substituição total de bebidas tradicionais indígenas pela cachaça, introduzida pelo contato interétnico. Contribui com a carência de ampliação de estudos na temática, analisando as consequências negativas do uso de álcool Maxakali. Enquanto estudos antropológicos enfatizam funções do beber tradicional e contemporâneo como “lubrificantes” sociais, as percepções sociais Maxakali ressaltam consequências negativas do uso da cachaça vendida ou trocada no contato interétnico. Interpretou-se no cotidiano, símbolos e significados dessas consequências, narradas por 21 lideranças em grupos focais. Com a substituição da Kaxmuk pelos Maxakali, ocorreram adaptações surgidas pelo contato interétnico, com relações negativas para quem bebe, suas família, aldeia e comunidade. No mundo-da-vida, as consequências negativas apresentaram-se em forma de acidentes, desarmonias conjugais, negligências, além de comportamentos violentos, doenças e mortes. Este estudo reforça a importância de produção de conhecimentos aprofundados e abrangentes visando a identificação de grupos vulneráveis em busca de soluções participantes.This study explores one of the most interesting and least studied issues in Brazil: the consequences of complex and contradictory experiences by replacing the traditional drinks by cachaça, introduced through interethnic contact. Given the rarity of the study of Maxakali alcohol consumption in research, this study aims to understand, from the native’s point of view, the negative aftereffect of alcohol consumption. Although anthropological studies emphasize functions of traditional and contemporary drinking as social “lubricants”, social perceptions of the Maxakali highlight the problems of cachaça bought through interethnic contact. Symbols and meanings of these consequences were interpreted through their daily life histories, recorded by 21 leaders in focus group. Through the interethnic contact, some adaptations have occurred in the Maxakali alcohol use, with negative consequences for those who drink, their families, their villages and their community. In the world-of-life, these changes these changes can be seen through accidents, insults, marital disharmony, neglects, violent behavior, illness and death. This study’s findings highlight the importance of producing comprehensive and in-depth knowledge in search of to identify vulnerable groups and to develop participatory solutions

Factors Associated to Endemic Dental Fluorosis in Brazilian Rural Communities

The present paper examines the relationship between hydrochemical characteristics and endemic dental fluorosis, controlling for variables with information on an individual level. An epidemiological survey was carried out in seven rural communities in two municipalities in the state of Minas Gerais, Brazil. The Thystrup & Fejerskov index was employed by a single examiner for the diagnosis of dental fluorosis. A sampling campaign of deep groundwater in the rural communities of interest was carried out concomitantly to the epidemiological survey for the determination of physiochemical parameters. Multilevel modeling of 276 individuals from seven rural communities was achieved using the non-linear logit link function. Parameters were estimated using the restricted maximum likelihood method. Analysis was carried out considering two response variables: presence (TF 1 to 9) or absence (TF = 0) of any degree of dental fluorosis; and presence (TF ≥ 5—with loss of enamel structure) or absence of severe dental fluorosis (TF ≤ 4—with no loss of enamel structure). Hydrogeological analyses revealed that dental fluorosis is influenced by the concentration of fluoride (OR = 2.59 CI95% 1.07–6.27; p = 0.073) and bicarbonate (OR = 1.02 CI95% 1.01–1.03; p = 0.060) in the water of deep wells. No other variable was associated with this prevalence (p > 0.05). More severe dental fluorosis (TF ≥ 5) was only associated with age group (p < 0.05). No other variable was associated to the severe dental fluorosis (p > 0.05). Dental fluorosis was found to be highly prevalent and severe. A chemical element besides fluoride was found to be associated (p > 0.05) to the prevalence of dental fluorosis, although this last finding should be interpreted with caution due to its p value

O acesso aos serviços públicos de saúde em área limítrofe entre municípios

Este artigo analisa o acesso aos serviços de saúde. O conceito de acessibilidade é descrito como uma característica dos serviços de saúde podendo ser abordado sob diferentes enfoques. Por isso o acesso aos serviços de saúde deve ser estabelecido em cada Unidade Básica de Saúde (UBS) com a participação efetiva, no processo, dos servidores de nível local e da comunidade. Foi empregada metodologia qualitativa, a pesquisa-ação e, para a coleta de dados, foram realizadas entrevistas e grupos focais. O trabalho foi desenvolvido junto às gerentes de duas UBS " Confisco, em Belo Horizonte, e Estrela Dalva, em Contagem " e moradores da área de abrangência das unidades. O acesso dos moradores aos serviços de saúde mostrou-se problemático por se tratar de uma área limítrofe entre dois municípios. Apesar de o trabalho ter sido desenvolvido durante dois anos, há dúvidas se ele contribuiu para a melhoria do acesso da população, em função das questões políticas que envolvem o tema. No entanto, toda a problemática detectada durante o desenvolvimento da pesquisa foi apresentada e debatida com os gestores de ambos os municípios.This study analyses access to health services. The concept of access is described as a characteristic of the health services and it may be approached in different ways. Therefore, access to health services must be determined by each Primary Care Unit with the participation of local staff and the community. The qualitative methodology was employed through action research, and data collection was conducted through interviews and focus groups. The study was conducted with the managers of two primary care units " Confisco, in Belo Horizonte, and Estrela Dalva, in Contagem -, and dwellers in the units' catchment area. The community's access to health services was difficult for it was a borderline area between two cities. Although the study lasted two years, doubts remain about whether it contributed to improve the access of the population, due to political matters involving the topic. However, all problems detected during the research were presented and debated with the administrators of both cities

Empoderamento e qualidade de vida de adolescentes trabalhadores assistidos por uma entidade filantrópica de apoio ao adolescente

O objetivo deste trabalho foi medir o empoderamento de adolescentes trabalhadores e testar sua possível associação com a qualidade de vida. Estudo transversal realizado com 363 adolescentes trabalhadores assistidos por uma Entidade Filantrópica de Apoio ao Adolescente. A coleta de dados ocorreu por meio da aplicação de dois questionários, sendo um utilizado para mensurar a qualidade de vida (WHOQoL-Bref) e as questões sobre empoderamento do Questionário Integrado para Medir Capital Social do Banco Mundial (QIMCS). A variável dependente (empoderamento) foi construída pelo agrupamento dos participantes, por meio da análise de segmentação. O teste Kruskal-Wallis foi utilizado para a comparação dos escores dos domínios do WHOQoL-Bref (físico, psicológico, relações sociais e meio ambiente) entre os clusters, com 5% de significância. Em relação à análise de segmentação, 126 (34,7%) adolescentes foram classificados como de baixo empoderamento, 161 (44,4%) formaram o grupo moderado e 70 (19,3%) possuíam maior empoderamento. O cluster com alto empoderamento apresentou as maiores médias dos escores de qualidade de vida em todos os domínios. O teste Kruskal-Wallis revelou diferenças estaticamente significantes entre os clusters para os domínios psicológico (p=0,001), relações sociais (p=0,003) e global (p=0,024). Concluiu-se que melhores escores de qualidade de vida foram encontrados no grupo de adolescentes com maior empoderamento

Response to: Arora, V.; Gupta, N.K.; Nath, D.K.; Tandan, A.; Chandra, P. Comments on “The Dental Aesthetic Index and Dental Health Component of the Index of Orthodontic Treatment Need as Tools in Epidemiological Studies”. Int. J. Environ. Res. Public Health 2011, 8, 3277–3286

In response to the Commentary submitted by Arora et al. [1], which has questioned some methodological issues in our article [2], we would like to respond item by item. [...