Incidence of Dental Caries and Associated Factors in the School Period in a Municipality in Southern Brazil

Objective: To estimate the incidence of dental caries and associated factors in the school period from six/seven to ten years of age. Material and Methods: A longitudinal study involving 168 children was followed up between 2015 and 2019 in the municipality of Palhoça, Brazil. The dependent variable was the caries incidence rate in the mixed dentition. The independent variables included information regarding demographic and socioeconomic status. Multivariate analyzes were carried out using Poisson Regression with a robust estimator. Variables with p <0.20 in the bivariate analysis were included in the adjusted model. Relative risks were estimated, as well as 95% confidence intervals. Results: Of 168 followed schoolchildren, 32 developed the disease, providing an incidence rate of 19.0%. Female children had a 10% higher risk [RR = 1.10 (95% CI 1.03; 1.18)] of developing caries than males. Also, children born from fathers with ≤ 8 years of schooling at baseline had a 9% higher risk [RR = 1.09 (95% CI 1.01; 1.16)] of developing dental caries compared to fathers with higher education. Conclusion: The incidence of dental caries in a four-year period was 19.0%. Females and children born from fathers with a lower level of education showed higher incidence rates

The Influence of the First Thousand Days of Life on Establishing Determinant Behaviors for Dental Caries in Childhood

Objective: To study the influence of the first thousand days of life on establishing determinant behaviors for dental caries in childhood. Material and Methods: Longitudinal retrospective study involving 664 children born in 2009 living in a southern Brazilian municipality was carried out. Data was collected through interviews with mothers and through child’s health card. Dependent variables were 1) tooth brushing onset after two years of age; 2) absent tooth brushing or once a day; 3) tooth brushing without adult supervision; 4) not having gone to the dentist until the age of 6; and 5) seek for dental services due to toothache at 6 years of age, over the last 30 days. Bivariate and multivariate analyses were performed using Poisson Regression to estimate relative risks (RR) and respective confidence intervals at the 95% accuracy level. Results: Mothers with lower schooling at child’s birth presented a higher risk of “child’s tooth brushing onset only after two years of age”, “brushing the teeth once a day only or not brushing” and with “child not having gone to the dentist until the age of 6”. Mothers who did not have a job when the child was born were associated with “not having gone to the dentist until the age 6”. Children with gastroesophageal reflux who underwent hospitalization for more than 2 days under age 2 were associated with “seeking dental services because of pain at 6 years of age over the last 30 days”. Conclusion: Higher risks of some determinant behaviors related to dental caries were associated with variables of the period of the first thousand days of life

What is the impact of national public expenditure and its allocation on neonatal and child mortality? A machine learning analysis

Background: Understanding the impact of national public expenditure and its allocation on child mortality may help governments move towards target 3.2 proposed in the 2030 Agenda. The objective of this study was to estimate the impacts of governmental expenditures, total, on health, and on other sectors, on neonatal mortality and mortality of children aged between 28 days and five years./ Methods: This study has an ecological design with a population of 147 countries, with data between 2012 and 2019. Two steps were used: first, the Generalized Propensity Score of public spending was calculated; afterward, the Generalized Propensity Score was used to estimate the expenditures’ association with mortality rates. The primary outcomes were neonatal mortality rates (NeoRt) and mortality rates in children between 28 days and 5 years (NeoU5Rt)./ Results: The 1% variation in Int$Purchasing Power Parity (Int$ PPP) per capita in total public expenditures, expenditure in health, and in other sectors were associated with a variation of -0.635 (95% CI -1.176, -0.095), -2.17 (95% CI -3.051, -1.289) -0.632 (95% CI -1.169, -0.095) in NeoRt, respectively The same variation in public expenditures in sectors other than health, was associates with a variation of -1.772 (95% CI -6.219, -1.459) on NeoU5Rt. The results regarding the impact of total and health public spending on NeoU5Rt were not consistent./ Conclusion: Public investments impact mortality in children under 5 years of age. Likely, the allocation of expenditures between the health sector and the other social sectors will have different impacts on mortality between the NeoRt and the NeoU5Rt

Incidência de excesso de peso corporal em crianças em idade escolar e sua relação com fatores pré-natais

Objective: To estimate the incidence of excess of body weight in the school period and explore possible association with prenatal factors. Methodology: An epidemiological study with a longitudinal design was carried out. All children from the first to the fifth grade of elementary school, aged between seven and 10 years old, enrolled in public and private schools and from families residing in Palhoça City, Santa Catarina State, who had participated in the previous stage of the study in 2015, were included. To obtain the BMI, weight and height were collected in schools. Data related to the prenatal period were obtained with interviews with mothers or guardians, at home. The analyses were performed using Poisson Regression with a robust estimator. Statistically significant variables and those with p ≤ 0.25 in the bivariate analysis were included in the multivariate. Results: 228 students were included. The incidence rate of excess weight was 19.3%, with 17.1% being overweight and 2.2% being obese. The results of the multivariate analysis showed that students who were born with Apgar in the first minute ≤ 7 had a statistically significant risk and 34% higher relative risk of developing excess weight in the school period. Conclusion: The incidence of overweight was 19.3%. Prenatal factors were not associated with incidence, except for a low Apgar score in the first minute.Objetivo: Estimar a incidência de excesso de peso corporal no período escolar e a associação com fatores pré-natais. Métodos: Estudo epidemiológico de delineamento longitudinal. Incluídas crianças com 10 anos matriculadas em escolas públicas e privadas e de famílias residentes em Palhoça/SC participantes da pesquisa em 2015. Para o índice de massa corporal, coletaram-se peso e estatura. Dados do período pré-natal foram obtidos em entrevistas com as mães ou responsáveis. As análises ocorreram por regressão de Poisson com estimador robusto. As variáveis estatisticamente significativas e aquelas com p ≤ 0,25 na análise bivariada foram incluídas na multivariada. Resultados: Foram incluídos 228 escolares. A taxa de incidência de excesso de peso foi de 19,3% — 17,1% de sobrepeso e 2,2% de obesidade. Os resultados da análise multivariada mostraram que escolares que nasceram com Apgar no primeiro minuto ≤ 7 apresentaram risco relativo estatisticamente significativo e independente 34% maior de desenvolver excesso de peso no período escolar. Conclusão: A incidência de excesso de peso foi de 19,3%. Fatores pré-natais não se mostraram associados à incidência, com exceção de baixo Apgar no primeiro minuto

First Thousand Days of Child Life and the Development of Risk Factors for Malocclusions

Objective: To identify the association between individual and socioeconomic factors during the first thousand days of the child\u27s life and the occurrence of risk behaviors for the development of malocclusions. Material and Methods: Cross-sectional study. A sample of 655 6-year-old schoolchildren and families was included. Interviews with mothers were performed at home. The dependent variables were risk behaviors to the development of malocclusions. Independent variables were socioeconomic conditions, aspects of gestation, birth and health of the child up to two years of age. Bivariate and multivariate analyzes were performed through Poisson regression. Results: Maternal education of less than eight years was independently associated with the interruption of exclusive breastfeeding until the fourth month (PR=1.58 CI 95%; 1.07; 2.37). Occupation of the mother with income [PR=1.26; 1.02; 1.56)], occupation of the father without income [PR=1.46 (1.01; 2.14)] were associated fwith interruption of breastfeeding until the sixth month. Pregnancy in adolescence [PR=0.83 (0.70; 0.98)] and nursery attendance [PR=1.15 (1.02; 1.28)] were associated with bottle use. Nursery attendance [PR=1.27 (1.01; 1.59)], hospitalization in the first 29 days of life [PR=1.34 (1.01; 1.80)], occurrence of reflux [PR=1.30 (1.01; 1.70)] were associated with pacifier using. Conclusion: Variables related to the period of the first thousand days of life are associated with higher risk behaviors for the occurrence of malocclusions

Prevalence and Associated Factors of Dental Trauma in Six-Year-Old School-Children

Objective: To estimate the prevalence and associated factors of dental trauma in 6-year-old school children in the city of Palhoça, Brazil. Material and Methods: Cross-sectional study nested in a cohort study. It involved a representative sample of school children born in 2009, residing in the municipality and regularly enrolled in public and private schools (n = 1,102). Clinical data were obtained through oral exams. To evaluate the incisal overjet, the distance in millimeters was measured horizontally from the labial surface of the lower central incisor to the labial surface of the upper incisor. Bivariate analyses were performed using the Chi-square test, with a p-value <0.05 considered statistically significant. Multivariate analyses using Poisson Regression were performed to identify independent associations between the prevalence and the independent variables studied. Results: Prevalence of dental trauma was 4.2% (95% CI 3.0-5.4). Dental trauma was statistically associated with studying in a private school (PR = 1.03; 95% CI 1.01-1.06) (p=0.016) and with inadequate lip coverage (PR = 1.08; 95% CI 1.01-1.14) (p=0.016). Conclusion: The prevalence of 4.2% of dental trauma in six-year-old children, associated with inadequate and greater lip coverage in children from private schools should be taken into account, since most teeth at this stage are newly erupted

Validação de uma escala de ansiedade para procedimentos diagnósticos prénatais

OBJECTIVE: To perform a cross-cultural adaptation of the Prenatal Diagnostic Procedures Anxiety Scale questionnaire for application in the Brazilian cultural context. METHODS: The translation and back translation processes followed internationally accepted criteria. A committee of experts evaluated the semantic, idiomatic, experimental and conceptual equivalence, proposing a pre-final version that was applied in 10.0% of the final sample. Afterwards, the final version was approved for the psychometric analysis. At that stage, 55 pregnant women participated which responded to the proposed Brazilian version before taking an ultrasound examination at a public hospital in Santa Catarina, in the year of 2017. The Edinburgh Postnatal Depression Scale was used as an external reliability parameter. The internal consistency of the instrument was obtained by Cronbach’s alpha. Validation was performed by exploratory factorial analysis with extraction of principal components by the Kaiser-Guttman method and Varimax rotation. RESULTS: The Cronbach’s alpha value of the total instrument was 0.886, and only the percentage of variance from item 2 (0.183) was not significant. The Kaiser-Guttman criterion defined three factors responsible for explaining 78.5% of the variance, as well as the Scree plot. Extraction of the main components by the Varimax method presented values from 0.713 to 0.926, with only item 2 being allocated in the third component. CONCLUSIONS: The Brazilian version is reliable and valid for use in the diagnosis of anxiety related to the performance of ultrasound procedures in prenatal care. Due to the lack of correlation with the rest of the construct, it is suggested that item 2 be removed from the final version.OBJETIVO: Proceder à adaptação transcultural do questionário Prenatal Diagnostic Procedures Anxiety Scale para aplicação no contexto cultural brasileiro. MÉTODOS: Os processos de tradução e retrotradução seguiram critérios aceitos internacionalmente. Um comitê de especialistas avaliou as equivalências semântica, idiomática, experimental e conceitual, propondo uma versão pré-final que foi aplicada em 10,0% da amostra final. Em seguida, foi aprovada a versão final para a análise psicométrica. Nessa etapa participaram 55 gestantes que responderam à versão brasileira proposta antes de realizarem um exame ultrassonográfico em um hospital público de Santa Catarina, no ano de 2017. A Edinburgh Postnatal Depression Scale foi utilizada como parâmetro de confiabilidade externa. A consistência interna do instrumento foi obtida pelo alfa de Cronbach. A validação foi realizada por análise fatorial exploratória com extração de componentes principais pelo método de Kaiser-Guttman e rotação Varimax. RESULTADOS: O alfa de Cronbach do instrumento total foi 0,886, e apenas o percentual de variância do item 2 (0,183) não foi significativo. O critério de Kaiser-Guttman definiu três fatores responsáveis por explicar 78,5% da variância, assim como o gráfico de Escarpa. A extração dos componentes principais pelo método Varimax apresentou valores de 0,713 a 0,926, sendo apenas o item 2 alocado no terceiro componente. CONCLUSÕES: A versão brasileira é confiável e válida para uso no diagnóstico de ansiedade relacionada à realização de procedimentos ultrassonográficos no pré-natal. Devido à falta de correlação com o restante do construto, sugere-se a retirada do item 2 da versão final

Prevalence and Associated Factors of Dental Trauma in Six-Year-Old School-Children

Objective: To estimate the prevalence and associated factors of dental trauma in 6-year-old school children in the city of Palhoça, Brazil. Material and Methods: Cross-sectional study nested in a cohort study. It involved a representative sample of school children born in 2009, residing in the municipality and regularly enrolled in public and private schools (n = 1,102). Clinical data were obtained through oral exams. To evaluate the incisal overjet, the distance in millimeters was measured horizontally from the labial surface of the lower central incisor to the labial surface of the upper incisor. Bivariate analyses were performed using the Chi-square test, with a p-value <0.05 considered statistically significant. Multivariate analyses using Poisson Regression were performed to identify independent associations between the prevalence and the independent variables studied. Results: Prevalence of dental trauma was 4.2% (95% CI 3.0-5.4). Dental trauma was statistically associated with studying in a private school (PR = 1.03; 95% CI 1.01-1.06) (p=0.016) and with inadequate lip coverage (PR = 1.08; 95% CI 1.01-1.14) (p=0.016). Conclusion: The prevalence of 4.2% of dental trauma in six-year-old children, associated with inadequate and greater lip coverage in children from private schools should be taken into account, since most teeth at this stage are newly erupted

Räumlich-relationierende Ausdrücke in Bildbeschreibungen italophoner DaF-Lerner

In der Arbeit wird anhand der Analyse eines Korpus aus schriftlichen Bildbeschreibungen italophoner Lerner von Deutsch als Fremdsprache das Beschreibenkönnen räumlicher Relationen untersucht (Niveau A1, A2 des GER). Auf der Grundlage des Könnensbegriffes von Bialystok (1994) besteht das Beschreibenkönnen darin, in den Bildbeschreibungen räumliche Kohärenz (Blühdorn/Foschi 2006) herzustellen. Untersucht wurde dabei auch die Entwicklung des Inventars räumlicher Ausdrücke und die Markierung der raumkodierenden Kasus Akkusativ und Dativ. Die Ergebnisse zeigen, dass A1/A2-Lerner einzelne Objekte statisch lokalisieren können, es aber nicht schaffen, die Gesamtkonstellation zu beschreiben, obwohl entsprechende Raumausdrücke verfügbar sind