Validação da estrutura interna da Escala Brasileira de Vulnerabilidade Odontológica

OBJETIVO: Avaliar evidências de validade da estrutura interna da Escala Brasileira de Vulnerabilidade Odontológica (EVO-BR) quando aplicada no Brasil. MÉTODOS: Trata-se de um estudo de natureza psicométrica, que busca validar uma escala construída através de evidências de estrutura interna. A coleta de dados foi realizada em 18 unidades básicas de saúde que executam a metodologia da Planificação da Atenção à Saúde, distribuídas nas cinco regiões do Brasil. A versão inicial da EVO-BR continha 41 itens que mediam vulnerabilidade odontológica e foram aplicados por em usuários com 18 anos ou mais, usuários do Sistema Único de Saúde, que estivessem nas unidades básicas de saúde para consulta por profissionais de nível superior. Para avaliação das evidências foram utilizadas as seguintes análises estatísticas: análise fatorial exploratória, confirmatória e network analysis. RESULTADOS: Participaram do estudo 1.753 usuários. Para adequação da amostra considerou-se a fatorabilidade obtida de Kaiser-Meyer-Olkin (KMO) = 0,65, Bartlett sphericity = 8019,7 e determinante da matriz de 0,008. A análise paralela inicial indicou um modelo de 4 dimensões e teve os itens ajustados conforme cargas fatorais (variaram de 0,38 a 0,99), comunalidades (0,13 a 0,89) e Pratt’s measure até que o modelo tivesse congruência nos princípios estatístico e interpretativo simultaneamente. O modelo final apresentou 15 itens, manteve a indicação de quatro dimensões pela análise paralela e com uma variância explicada de 68,56%. CONCLUSÕES: A EVO-BR é uma escala validada para mensurar vulnerabilidade odontológica, e pode contribuir para organização do acesso a equipe de saúde bucal na atenção primária à saúde por meio da estratificação da população, como recomendado na planificação

Factors Associated with SARS-CoV-2 Infection among Oral Health Team Professionals

Objective: To analyze the factors associated with the SARS-CoV-2 infection among oral health professionals. Material and Methods: This was a cross-sectional study in the city of São Paulo, São Paulo State, Brazil. Professionals from three different categories were included: dental surgeons (DS), dental assistants (DA), and dental hygienists (DH). A questionnaire was created on a digital platform and sent via institutional email to each subject. The questionnaire contained 32 questions about sociodemographic, work, and behavior factors. The data about SARS-CoV-2 infection was confirmed through RT-PCR exams. Descriptive (absolute and relative frequencies) and inferential analyses (chi-squared or Fisher’s exact test) (p<0.05) were performed. Results: There was a SARS-CoV-2 infection prevalence of 3.8% for DS, 30.0% for DH, and 33.3% for DA. SARS-CoV-2 was associated with a lower income (p=0.027), a lower education level (p=0.011), the category of technical professionals (DA and DH) (p=0.025), and using public transportation to commute to work (p=0.009). Conclusion: Sociodemographic factors like lower income and education levels and work factors like job category and public transportation were associated with COVID-19 among professionals on the oral health teams

Factors Associated with SARS-CoV-2 Infection among Oral Health Team Professionals

Objective: To analyze the factors associated with the SARS-CoV-2 infection among oral health professionals. Material and Methods: This was a cross-sectional study in the city of São Paulo, São Paulo State, Brazil. Professionals from three different categories were included: dental surgeons (DS), dental assistants (DA), and dental hygienists (DH). A questionnaire was created on a digital platform and sent via institutional email to each subject. The questionnaire contained 32 questions about sociodemographic, work, and behavior factors. The data about SARS-CoV-2 infection was confirmed through RT-PCR exams. Descriptive (absolute and relative frequencies) and inferential analyses (chi-squared or Fisher’s exact test) (p<0.05) were performed. Results: There was a SARS-CoV-2 infection prevalence of 3.8% for DS, 30.0% for DH, and 33.3% for DA. SARS-CoV-2 was associated with a lower income (p=0.027), a lower education level (p=0.011), the category of technical professionals (DA and DH) (p=0.025), and using public transportation to commute to work (p=0.009). Conclusion: Sociodemographic factors like lower income and education levels and work factors like job category and public transportation were associated with COVID-19 among professionals on the oral health teams

Multiancestry analysis of the HLA locus in Alzheimer’s and Parkinson’s diseases uncovers a shared adaptive immune response mediated by HLA-DRB1*04 subtypes

Across multiancestry groups, we analyzed Human Leukocyte Antigen (HLA) associations in over 176,000 individuals with Parkinson’s disease (PD) and Alzheimer’s disease (AD) versus controls. We demonstrate that the two diseases share the same protective association at the HLA locus. HLA-specific fine-mapping showed that hierarchical protective effects of HLA-DRB1*04 subtypes best accounted for the association, strongest with HLA-DRB1*04:04 and HLA-DRB1*04:07, and intermediary with HLA-DRB1*04:01 and HLA-DRB1*04:03. The same signal was associated with decreased neurofibrillary tangles in postmortem brains and was associated with reduced tau levels in cerebrospinal fluid and to a lower extent with increased Aβ42. Protective HLA-DRB1*04 subtypes strongly bound the aggregation-prone tau PHF6 sequence, however only when acetylated at a lysine (K311), a common posttranslational modification central to tau aggregation. An HLA-DRB1*04-mediated adaptive immune response decreases PD and AD risks, potentially by acting against tau, offering the possibility of therapeutic avenues

Evolution of the Oral Health indicators of the Strategy of Family Health in Campo limpo, south zone of São Paulo, 2009 to 2011

Orientador: Antonio Carlos PereiraDissertação (mestrado profissional) - Universidade Estadual de Campinas, Faculdade de Odontologia de PiracicabaResumo: Este trabalho tem como objetivo a avaliação pós-implantação das 21 Equipes de Saúde Bucal (ESB) da parceria entre a Sociedade Beneficente Israelita Brasileira Hospital Albert Einstein (SBIBAE) e a Secretaria Municipal de Saúde de São Paulo (SMS/SP) na região do Campo Limpo/Vila Andrade que fica na Zona Sul da cidade de São Paulo, através da evolução dos indicadores Rendimento, Acesso, Percentual de faltas e Percentual de urgências, analisados no período de 2009 a 2011. Foram utilizados os dados dos mapas de produção ambulatorial dos profissionais das ESB desta parceira, instrumento oficial utilizado pela SMS/SP para acompanhar o desempenho dos profissionais da saúde bucal. Para os indicadores Percentual de urgência, Rendimento e Acesso houve uma diferença significativa entre os anos analisados. Para o indicador Percentual de faltas não houve diferença estatisticamente significante. Quando feita a analise mensal, destaca-se que no início da implantação do serviço ocorreu oscilação, podendo indicar que o trabalho foi consolidado ao longo dos meses, sendo capaz de receber novos profissionais e aumento da população atendida. Ao se comparar os indicadores do período com as metas pactuadas com SMS/SP é possível perceber que as ESB tiveram bom desempenho. Conclui-se que os resultados alcançados junto às metas pactuadas com SMS/SP certamente refletem o aumento do número de profissionais, o amadurecimento dos processos de trabalho dessas ESB e a otimização da mão de obra disponível para realização das atividades. O entendimento destes resultados será importante para nortear as ações das ESB para os anos seguintes e para avaliar o cumprimento das metasAbstract: This study makes an evolution after inserting 21 Oral Health Teams's (OHT) in partnership between Sociedade Beneficente Israelita Brasileira Hospital Albert Einstein (SBIBAE) and the Local Secretary of Health of São Paulo (SMS/SP) in the Campo Limpo/Vila Andrade region in the South Zone of São Paulo, by the indicators Incomes, Acess to Service, Percentage of Absence and Percentage of Urgencies, analyzed in the period from 2009 to 2011. For this research, it was used the data from the clinical productivity mappings of the OHT professionals in this partnership, data that represents the official instrument used by SMS/SP to keep up with performance of oral health professionals. For the indicators Percentage of Urgency, Incomes and Access to Services, there was a significant difference between the analyzed years. For the Percentage of Absences there was not any significant difference, statistically. When the monthly analysis was made, I highlighted oscillation in the beginning of the implantation of the services, what may indicate that the work was consolidated over months, being capable of receiving new professionals and the targets agreed with SMS/SP, is easy to note that the OHT's had a good performance. It is concluded that the achieve results with the agreed targets surely reflect the rise of the number of professionals, the maturing of the OHT's working processes and the optimization of the available manpower for these activities. The understanding of these results will be substantial for guiding the OHT's actions for the following years and for evaluating the goals accomplishmentMestradoOdontologia em Saude ColetivaMestra em Odontologia em Saúde Coletiv

Psychological Impact of the COVID-19 Pandemic on Dentists in Latin America’s Epicenter: São Paulo, Brazil

The present study aimed to assess the prevalence and associated factors of stress and anxiety symptoms among dentists during the COVID-19 pandemic in the state of São Paulo, Brazil. A structured questionnaire was sent electronically to 93,280 dentists with active registration in the Dental Council of São Paulo, Brazil, enquiring about information regarding the first-wave peak period in Brazil. Descriptive analyses of background characteristics, perceptions of preparedness, and psychological impact were calculated. Multiple logistic regression analysis was performed, and independent variables that showed p < 0.20 were used in the adjusted logistic regression model to compare the psychological impact on dental professionals. Among the 2113 respondents, female participants had 63% lower chance of reporting anxiety than males. Older dentists had a lower likelihood of reporting anxiety compared to 21–30-year-old dentists (p ≤ 0.05). Dentists working in the public health service were 1.78 times more likely to report anxiety than those who worked in private practice. Finally, dentists in the COVID-19 high-risk group and those with a family or team member with a positive COVID-19 diagnosis were more likely to have anxiety. This study can help dental and other healthcare professionals to better understand the consequences of COVID-19 in terms of mental health

Evolution of post-deployment indicators of oral health on the Family Health Strategy

<div><p> Objective To evaluate the evolution of indicators after the implementation of 21 Oral Healthcare Teams in the Family Health Strategy. Methods We used data from outpatient services of Oral Healthcare Teams to evaluate efficiency, access, percentage of absences and emergencies of oral healthcare professionals who worked in the partnership between the Sociedade Beneficente Israelita Brasileira Hospital Albert Einstein and the Secretaria Municipal de Saúde de São Paulo, during the period 2009-2011. Results Percentages of emergencies, income, and access showed a significant difference during the period analyzed, but no difference for percentage of absences was found. When monthly analysis was made, it is noteworthy that at the beginning of service implementation a fluctuation occurred, which may indicate that the work was consolidated over the months, becoming capable of receiving new professionals and increasing the population served. Comparison of the indicators in that period with the goals agreed upon between the Sociedade Beneficente Israelita Brasileira Hospital Albert Einstein and the Secretaria Municipal de Saúde de São Paulo made it possible to notice that the Oral Health Teams had a good performance. Conclusion The results showed that the goals were achieved reflecting the increasing number of professionals, the maturing of work processes in the Oral Health Teams, and optimization of the manpower available to perform the activities. Understanding these results will be important to guide the actions of Oral Health Teams for the following years and to assess the achievement of goals.</p></div

New insights into the genetic etiology of Alzheimer’s disease and related dementias

Characterization of the genetic landscape of Alzheimer’s disease (AD) and related dementias (ADD) provides a unique opportunity for a better understanding of the associated pathophysiological processes. We performed a two-stage genome-wide association study totaling 111,326 clinically diagnosed/‘proxy’ AD cases and 677,663 controls. We found 75 risk loci, of which 42 were new at the time of analysis. Pathway enrichment analyses confirmed the involvement of amyloid/tau pathways and highlighted microglia implication. Gene prioritization in the new loci identified 31 genes that were suggestive of new genetically associated processes, including the tumor necrosis factor alpha pathway through the linear ubiquitin chain assembly complex. We also built a new genetic risk score associated with the risk of future AD/dementia or progression from mild cognitive impairment to AD/dementia. The improvement in prediction led to a 1.6- to 1.9-fold increase in AD risk from the lowest to the highest decile, in addition to effects of age and the APOE ε4 allele