Dissertations / Theses: 'Dental public health Dental Health Services'

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Koopu, Pauline Irihaere, and n/a. "Kia pakari mai nga niho : oral health outcomes, self-report oral health measures and oral health service utilisation among Maori and non-Maori." University of Otago. School of Dentistry, 2005. http://adt.otago.ac.nz./public/adt-NZDU20070502.152634.

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Health is determined by the past as well as the present; the health status of indigenous peoples has been strongly influnced by the experience of colonisation and their subsequent efforts to participate as minorities in contemporary society while retaining their own ethnic and cultural identities. Colonial journays may have led to innovation and adaptation for Maori, but they have also created pain and suffering from which full recovery has yet to be felt (Durie, 2001). The oral health area can be described as having considerable and unacceptable disparities between Maori and non-Maori (Broughton 1995; Thomson, Ayers and Broughton 2003). Few reports have been conducted concerning Maori and patterns of oral health service utilisation, however a lower service utilisation among Maori than non-Maori has been noted (TPK 1996; Broughton and Koopu 1996). Overall, Maori oral health is largely unknown due to a paucity of appropriate research. This research aims to provide new information by describing Maori oral health outcomes over the life course, within a Kaupapa Maori Research (KMR) methodology. In general, the basic tenets presented for KMR are: (1) to prioritise Maori - from the margin to the centre; (2) to be Maori controlled - by Maori, for Maori; (3) to reject �victim-blame� theories; and (4) to be a step towards action and change in order to improve Maori oral health outcomes. The aims of this research are to: 1. Describe the occurrence of caris at ages 5, 15, 18 and 26 and periodontal disease at age 26 years for Maori. 2. Describe self-reported oral health, self-reported dental aesthetics and oral health service utilisation among Maori at ages 5, 15, 18 and 26. 3. Compare the above oral health characteristics between Maori and non-Maori . 4. Investigate the determinants of any differences in oral health outcomes between Māori and non-Maori using a KMR methodology. The investigation involves a secondary analysis of data from the Dunedin multidisciplinary Health and Development study (DMHDS). The existing data-set was statistically analysed using SPSS (SPSS Inc, Chicago, USA). Descriptive statistics were generated. The levels of statistical significance were set at P< 0.05. Chi-square tests were used to compare proportions and independent sample t-tests or ANOVA were used for comparing means. A summary of the Maori/non-Maori analysis shows that, for a cohort of New Zealanders followed over their life-course, the oral health features of caries prevalence, caries severity, and periodonal disease prevalence are higher among Maori compared to non-Maori. In particular, it appears that while Maori females did not always have the highest prevalence of dental caries, this group most often had a higher dmfs/DMFS for dental caries, compared to non-Maori. As adolescents and adults, self-reported results of oral health and dental appearance indicate that Maori males were more likely to report below average oral health and below average dental appearance, when compared to non-Maori. However, at age 26, non-Maori males made up the highest proportion of episodic users of oral health services. This study has a number of health implications: these relate specifically to the management of dental caries, the access to oral health services, and Maori oral health and the elimination of disparities. These are multi-levelled and have implications for health services across the continuum of care from child to adult services; they also have public health implications that involve preventive measures and the broader determinants of health; and involve KMR principles than can be applied to oral health interventions and dental health research in general. Dental diseases and oral health outcomes, such as dental anxiety and episodic use of services, are a common problem in a cohort of New Zealanders with results demonstrating ethnic disparities between Maori and on-Maori. As an area of dentistry that has had very little research in New Zealand, the findings of this study provide important information with which to help plan for population needs. The KMR approach prioritises Maori and specifically seeks to address Maori oral health needs and the elimination of disparities in oral health outcomes. While the issues that are raised may be seen as the more difficult to address, they are also more likely to achieve oral health gains for Maori and contribute to the elimination of disparities.

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Brennan, David S. "Factors influencing the provision of dental services in private general practice /." Title page, contents and abstract only, 1999. http://web4.library.adelaide.edu.au/theses/09PH/09phb838.pdf.

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Dean, Lesa. "Dental Care in Long-Term Care Facilities of Warren County, Kentucky." TopSCHOLAR®, 1986. https://digitalcommons.wku.edu/theses/2252.

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Many physical changes occur as one ages, including changes associated with the oral cavity. A review of the literature suggests that the provision of dental care to institutionalized elderly patients presents problems due to a variety of factors. The purpose of this study is to assess the level or dental care provided to residents of long-term care facilities located in Warren County, Kentucky. In addition, secondary objectives Include the ascertainment of who provides dental care to residents and the amount or in-service dental training made available to staff members of the facility. Each administrator of the long term care facilities located in Warren County participated in an *interview conducted by the author. During the interview, information was obtained for a 21 item questionnaire concerning the facility, the number and age range or the residents, and types of dental services provided within the facility. Results obtained from the questionnaire indicated that 77 percent or the residents in long-tern care facilities in Warren County are 70 years of age or older. No significant differences were noted in the types or dental services provided to residents. However, the dental services provided ranged from those that were obtained in a private dental office via transportation or the resident to outside dental facilities to routine oral hygiene measures carried out by staff members employed by the facility. The findings revealed significant differences in the dental status of the MRDD residents when compared to the nursing home residents. Other findings indicated that none of the long-term care facilities had dental operatories or dental radiographic equipment on the premises. Additional research would be required in order to address uncertainties discovered in the study. A followup to the questionnaire Interview with the consulting dentists may be included to determine to what capacity and to what extent they are utilized by the facilities. Other recommendations include the utilization of entrance dental examinations to determine if services offered do meet the needs of the residents and periodic dental examinations to aid in detection and thus reduce the prevalence of dental diseases in this population.

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Pendharkar, Bhagyashree. "Fourth year dental students' barriers to tobacco intervention services." Thesis, University of Iowa, 2009. https://ir.uiowa.edu/etd/419.

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In order to facilitate effective tobacco cessation services within dental school clinics, it is necessary to understand the perceived barriers encountered by dental students while providing these services. The aim of this study was to identify which factors fourth year dental students perceive to be associated with barriers to providing tobacco intervention services. A written survey was developed and completed by the incoming fourth year dental students at the University of Iowa College of Dentistry in 2008. The survey assessed the perceived barriers to providing tobacco intervention services and related factors. Descriptive, bivariate and logistic regression analyses were conducted. The response rate was 97 percent. Some of the most frequently reported barriers included: patient's resistance to tobacco intervention services (96%), inadequate time available for tobacco intervention services (96%) and forgetting to give tobacco intervention advice (91%). The following variables were significantly (p<0.05) related to greater perceived barriers in providing tobacco intervention services: lower "adequacy of tobacco intervention curriculum coverage of specific topics covered over the previous three years" and "perceived importance of incorporating objective structured clinical examination teaching method for learning tobacco intervention." Students could benefit from additional didactic training and enhanced clinical experience in order to facilitate effective intervention services in the dental school.

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Al, Darwish Mohammed S. "Dental caries, oral health and life style variables among school children in Qatar." Thesis, University of Gloucestershire, 2014. http://eprints.glos.ac.uk/940/.

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Background: Effective delivery of dental services must be based on reliable information regarding the prevalence and severity of disease in the target population. Evaluation of the various factors known to influence the severity and progression of disease is essential for health policy makers to promote oral health resources and address oral health needs. Objective: The overall aim of this research is to describe the situation of dental caries and investigate the associations of level of oral health knowledge, teeth irregularity, BMI and other life style variables (TV viewing, internet use, passive smoking and dietary habits) with dental caries, including the impact of socio-demographic factors amongst school children in Qatar. Materials and methods: A cross-sectional study was conducted in Qatar from October 2011 to March 2012. A total of 2,113 children aged 12-14 years were randomly selected from 16 schools from different areas. Clinical examination was conducted by three calibrated examiners using World Health Organization criteria for diagnosing dental caries. Teeth irregularity was determined clinically according to a method described by Björk et al (1964). A pre-tested and structured questionnaire was used to assess oral health knowledge and life style data. Data analyses were performed. Results: The mean decayed, missing and filled teeth index values was 4.62 (±3.2), 4.79 (±3.5), and 5.5 (±3.7), respectively, for the 12, 13 and 14 year old children. The caries prevalence was 85%. The mandibular incisors and canines were least likely to be affected by dental caries, while maxillary and mandibular molars were the most frequently attacked by dental caries. Of the total sample, only one quarter reported a high level of oral health knowledge. There were more incidences of teeth crowding (44.1%) than teeth spacing (9.5%). The overall prevalence of underweight, overweight, and obesity was 5%, 10%, and 5% respectively. Almost half of the children spent > two hours watching television and 46% spent > two hours using internet. Approximately 35.8% of children had exposure to passive smoking. Concerning dietary habits, 99.4% of children consumed sugar containing snacks in between meals. Approximately 65% consumed sugar containing snacks within one hour of bed time. Almost 49.1% skipped eating breakfast regularly and 22.7% skipped eating lunch regularly. Around 83.8% consumed diary snacks in between meals. Overall, 74.2% drank tea in-between meals and 80.1% chewed gum in-between meals. All variables were affected by socio-demographic factors, but significant differences were found in female children in that they were more at risk to dental caries than male children. Also, children who resided in semi-urban areas were more at risk to dental caries than children who resided in urban areas. The occurrence of dental caries is significantly associated with the level of oral health knowledge, teeth irregularity, and other life style variables. Conclusion: The need to reduce sedentary behaviors and to promote a more active and healthy lifestyle is becoming increasingly essential in Qatar. Implementation of a community-based preventive oral health programs on a healthy diet and practices of adequate oral hygiene should be promoted in schools through integration into the school curriculum and services to combat the growing problem of dental caries.

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Broughton, John, and n/a. "Oranga niho : a review of Maori oral health service provision utilising a kaupapa maori methodology." University of Otago. Dunedin School of Medicine, 2006. http://adt.otago.ac.nz./public/adt-NZDU20070404.165406.

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The goal of this study was to review Maori oral health services utilising a kaupapa Maori framework. The aims of the study were to identify the issues in the development, implementation and operation of Maori dental health services within each of the three types of Maori health providers (mainstream, iwi-based, partnership). The three Maori oral health services are: (i) Te Whare Kaitiaki, University of Otago Dental School, Dunedin. (ii) Te atiawa Dental Service, New Plymouth. (iii) Tipu Ora Dental Service, in partnership with the School Dental Service, Lakeland Health, Rotorua. Method: A literature review of kaupapa Maori research was undertaken to provide the Maori framework under which this study was conducted. The kaupapa Maori methodology utilised the following criteria: (i) Rangatiratanga: The assertion of Maori leadership; (ii) Whakakotahitanga: A holistic approach incorporating Te Whare Tapa Wha; (iii) Whakapapa: The origins and development of oranga niho; (iv) Whakawhanuitanga: Recognising and catering for the diverse needs of Maori; (iv) Whanaungatanga: Culturally appropriate forms of relationship management; (v) Maramatanga: Raising Maori awareness, health promotion and education; and (vi) Whakapakiri: Recognising the need to the build capacity of Maori health providers. Ethical approval was granted by the Otago, Bay of Plenty and Taranaki Ethics Committees to undertake interviews and focus groups with Maori oral health providers in Dunedin, Rotorua and New Plymouth. Information was also sought from advisors and policy analysts within the Ministry of Health. A valuable source of information was hui korero (speeches and/or discussion at Maori conferences). An extensive literature was undertaken including an historical search of material from private archives and the now defunct Maori Health Commission. Results: An appropriate kaupapa Maori methodology was developed which provided a Maori framework to collate, describe, organise and present the information on Maori oral health. In te ao tawhito (the pre-European world of the Maori) there was very little if any dental decay. In te ao hou (the contemporary world of the Maori) Maori do not enjoy the same oral health status as non-Maori across all age groups. The reasons for this health disparity are multifactorial but include the social determinants of health, life style factors and the under-utilisation of health services. In order to address the disparities in Maori oral health, Maori providers have been very eager to establish kaupapa Maori oral health services. The barriers to the development, implementation, and operation of a kaupapa Maori oral health service are many and varied and include access to funding, and racism. Maori health providers have overcome the barriers through two strategies: firstly, the establishment of relationships within both the health sector and the Maori community; and secondly, through their passion and commitment to oranga niho mo te iwi Maori (oral health for all Maori). The outcome of this review will contribute to Maori health gain through the recognition of appropriate models and strategies which can be utilised for the future advancement of Maori oral health services, and hence to an improvement in Maori oral health status. Conclusion: This review of Maori oral health services has found that there are oral health disparities between Maori and non-Maori New Zealanders. In an effort to overcome these disparities Maori have sought to provide kaupapa Maori oral health services. Whilst there is a diversity in the provision of Maori oral health services, kaupapa Maori services have been developed that are appropriate, effective, accessible and affordable. They must have the opportunity to flourish.

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Valencia, Alejandra. "Racial and ethnic disparities in access and utilization of dental services among children in Iowa:." Thesis, University of Iowa, 2010. https://ir.uiowa.edu/etd/754.

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Even though the oral health of Americans has improved greatly in the last 50 years, some specific groups of the population have been left behind. Latinos, children and adults, bear a disproportionate burden of oral diseases. Latino children, the fastest growing minority group of children in the US, are affected disproportionately by oral diseases like dental caries compared to other groups. Understanding the difficulties and barriers that these children have to utilize dental care will help us in the future to develop effective programs to reduce health disparities in this segment of the population. The purpose of this study is to identify the factors that determine dental services access and utilization by children in the state of Iowa. Emphasis will be given to differences in utilization of dental services among different racial/ethnic groups. Additionally, the study will describe and compare difficulties in utilization of care among Latino children whose parents answered the survey in English (LE) and those who answered it in Spanish (LS). In order to address these objectives existing data from the Iowa Child and Family Household Health Survey 2005 (HHS) were analyzed. The dependent variable for the study was utilization of dental services. This outcome variable was dichotomized as whether or not the child had a dental visit in the last year. Characteristics of study subjects were first analyzed through descriptive statistics. Bivariate analyses were conducted to assess associations between the dependent variable and independent variables. Multiple logistic regression was used to identify factors associated with utilization of dental services in Iowa's children, and for each different racial and ethnic group. Seven factors were related to the time of the last dental visit for Iowa children: Having a regular source of dental care, dental insurance status, having a dental need in the past 12 months, brushing habits, the age of the children, and family income. The same seven factors were correlated to having a dental visit for white children. For African-American children, having a regular source of dental care, dental insurance status, and having a dental need in the last 12 months were the factors that were found associated to the time of the last dental check-up. For the Latino Spanish children, having a regular source of dental care and the age of the children were factors associated to dental utilization. Finally, for the Latino English children, the only factor associated with having a dental visit was having a regular source of dental care. Information from this research gives policy makers, public health workers, and clinicians an overview of oral health disparities affecting children in the state. For those agencies in Iowa interested in the improvement of access and utilization of dental services for minority children, this project gives important inside about the factors related to the use of services for different racial/ethnic groups in the state.

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Holt, Nicole. "An Investigation of the Relationship Between Child, Family, and Community Factors and Early Childhood Oral Health and the Utilization of Dental Health Services." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etd/3242.

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Background / Objective: Children under the age of 5 years bear a disproportionate burden of oral disease. The aim of this study is to investigate how child, family, and community determinants impact dental care utilization, and parental report of child’s oral health. Methods: Data for this study came from the 2011/2012 National Survey of Children’s Health for children aged 1 to 5 years old. Dependent variables evaluated were if the child had an oral health problem, been to a dentist in the past year, and parents description of the child’s teeth. Independent variables were selected from child, family, and community levels. Binary logistic methods were applied to each outcome and predictor variable. Stepwise logistic regression models were constructed for child, family, and community variables. Additionally the mediating effect of oral health services utilization in the association between child, family and community factors and parental perception of child’s oral health was evaluated. National results and Health Resource Service Area (HRSA) region IV results were compared. Results: In the national (n=24,875) and HRSA region IV sample (n=4,017) 9.7% and 10.2% of caregivers, reported that the child had an oral health problem in the past 12 months. Fewer than half (46.7%) of caregivers reported that their child had visited a dentist in the past 12 months. Absence of neighborhood cohesion, neighborhood amenities, and residence in metropolitan statistical area all had positive significant effects on children seeing a dentist. There was a mediating effect by utilization of oral health services between child with special health care needs (p=0.005), number of children (p=0.045) and adults (p=0.046) in the household, and tobacco use (p=0.018) and parents perception of oral health in the HRSA region IV population. Conclusion: This study identified several factors as correlates of poor oral health outcomes. Our results expand our knowledge of early childhood oral health by studying how oral health is impacted not only by child factors but also the family and community at large. Our results begin identifying the unique constellation of risk factors that contribute to early childhood oral health.

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Willenberg, Danae Joy. "Dental Service Utilization in HIV-Infected Adults." Case Western Reserve University School of Graduate Studies / OhioLINK, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=case1333744766.

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Young, Mairi Anne. "Optimising the role of the dental health support worker in Childsmile Practice : a comparative Realist approach." Thesis, University of Glasgow, 2017. http://theses.gla.ac.uk/8111/.

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Background: Childsmile, the national oral health improvement programme for children in Scotland, aims to reduce oral health inequalities and improve access to dental services. Childsmile is delivered, in part, by a new category of lay or community-based worker known as a Dental Health Support Worker (DHSW) who supports families to improve oral health behaviours and attend a dental practice. Findings from Childsmile’s national process evaluation indicated there was widespread variation in delivery of the DHSW role and additional research was required to further understand and develop programme theory for the DHSW role; and clarify areas of variation which were adaptive and which were a risk to the programme meeting its desired objectives. Aims: The overarching aim was to gain further understanding of which factors and variants (contextual and those associated with programme delivery) impact on effectiveness of the DHSW role within Childsmile Practice. This research is a component study of the national Childsmile evaluation strategy. Findings will be fed back to the Childsmile programme to optimise delivery of the role and to enable future evaluation of the role’s impact. Methods: Learning and evidence generation was triangulated from two phases of research, comprising three component studies. Phase 1 comprised the sensitising study and comparative case studies: both provided learning from within Childsmile. The sensitising study was designed as a scoping exercise using qualitative data collection methods. The aim was to establish existing programme theory and explicate delivery of the DHSW role, while uncovering deviation (from programme theory) and variation within and between NHS boards. Findings were used to design three comparative case studies, comprising one DHSW and key stakeholders involved in delivery of the role from three NHS boards. The comparative case studies employed qualitative data collection methods; and were designed to address the overarching aim, and explore the casual links between context, delivery, and outcomes in delivery of the role using Realist-inspired analysis. Phase 2 comprised a Realist Review to provide learning from out with Childsmile. The aim was to gain an understanding of which components of child health interventions, delivered by lay health workers to parents, could influence ‘child health parenting behaviours’. Findings and Conclusions: Findings indicated that in terms of motivational readiness to engage with positive oral health parenting behaviours (POHPBs) there were three types of families referred to the DHSW for support: low, moderate, and high-risk. It was established that to address programme aims DHSWs ought to support moderate-high risk families, yet DHSWs only had capacity to support low-moderate risk families. Findings demonstrated that the Public Health Nurses/Health Visitors were best placed to triage families according to their needs and motivational readiness. The peer-ness of the DHSW role was found to positively influence parental engagement with the programme and facilitate person-centred support. However, an embedded ‘sweetie culture’ and health damaging environments were found to negatively impact on parents’ self-efficacy and perceived locus of control to engage with POHPBs. Learning indicated that: delivery over a prolonged period of time; incorporation of the programme into the Early Years Pathway and GIRFEC policy; and recent changes to the Children and Young Person (Scotland) Act (2014), served to embed Childsmile within the NHS boards and facilitated stakeholder buy-in, which positively impacted on delivery of the role. From the learning derived within and out with Childsmile the recommendations for the DHSW role included: (1) DHSW support should move away from a primarily information provision and facilitation of families into dental practice role, and incorporate socio-emotional and person-centred support; (2) The DHSW role should be redefined to support moderate-high risk families; and interpretation and application of referral criteria should be addressed to ensure continuity with who is referred for support; and (3) Programme theory for the DHSW role should be refined and future evaluative effort should concentrate on assessing impact.

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Smith, Angel. "Oral Health Literacy of Parents and Dental Service Use for Children Enrolled in Medicaid." ScholarWorks, 2014. https://scholarworks.waldenu.edu/dissertations/73.

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Many people in the United States have untreated dental disease due to a lack of dental insurance, a lack of oral health knowledge, and a lack of priority placed on dental health. Despite an increase in dental service use by Medicaid recipients as a result of local programs, children enrolled in Medicaid often have low rates of use of dental services. Using the health literacy framework of the Paasche-Orlow and Wolf (POW) model, the purpose of this study was to explore to the relationship between oral health literacy of parents and dental service use for children enrolled in Medicaid and the differences in use rates between preventive and restorative services. A cross-sectional research design was employed within a convenience sample of parents who presented to a nonprofit clinic for a medical appointment. Participants completed a demographic profile, an oral health questionnaire, and REALD-30 survey. Responses were correlated with dental claims retrieved from 1 reference child for each parent. Pearson's correlation revealed no significant relationship between oral health literacy and dental service utilization, r = -.056 (p = .490). An ANOVA revealed no difference in utilization between preventive and restorative services, F (2, 149) = .173, p = .841, Ã§2 = .002. However, high rates of use for restorative services were observed, suggesting a high prevalence of tooth decay in children. Although this study did not find a significant relationship between oral health literacy and dental utilization, barriers continue to exist that contribute to the high rates of tooth decay in children enrolled in Medicaid. This study impacted social change by highlighting the importance of preventive care in reducing the prevalence of tooth decay.

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Ayach, Carlos. "Sistema de auditoria no SUS : análise dos dados de produção e glosas no serviço odontológico na rede pública /." Araçatuba : [s.n.], 2011. http://hdl.handle.net/11449/95398.

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Orientador: Suzely Adas Saliba Moimaz Banca: Rogério Nogueira de Oliveira Banca: Luís Carlos Cavalcante Galvão Resumo: O Sistema de Auditoria no setor saúde é fundamental, pois permite a avaliação da veracidade das informações e a resolubilidade da prestação de serviços, pressupondo o desenvolvimento de um modelo de atenção adequado. Nesta pesquisa, objetivou-se analisar as atividades da auditoria no Sistema Único de Saúde no serviço de saúde bucal do município de Aquidauana (MS); fazer o levantamento das principais justificativas de glosas e das perdas de produção; analisar as atividades desenvolvidas pelas equipes da Estratégia da Saúde da Família. É um estudo epidemiológico de série histórica retrospectiva, com abordagem quantitativa, entre os anos de 2001 a 2010. Foi realizada análise documental e revisão bibliográfica sobre os sistemas de auditoria e o papel do auditor no serviço odontológico. Para o levantamento dos dados de produção, perdas, justificativas de glosas e cumprimento de metas foram utilizadas respectivamente, o sistema de informação do DATASUS, relatórios realizados pelo Sistema Municipal de Auditoria do município de Aquidauana (MS), relatórios dos indicadores propostos pelos Decretos nº 11.684/2004 e nº 12.005/2005 da Secretaria Estadual de Saúde do Mato Grosso do Sul que estabelece mensalmente o mínimo de 10 visitas domiciliares, 26 tratamentos completados e uma atividade educativa. Os resultados mostraram que a atuação da auditoria é abrangente no gerenciamento do sistema, consistindo no controle, avaliação, supervisão e orientação, bem como na garantia da participação social e acesso aos serviços. Neste período foram apresentados 921.300 procedimentos odontológicos; sendo 223.226 (24,2%) procedimentos individuais e 698.074 (75,8%) coletivos. Ocorreram 23.881 glosas (2,6%), sendo 10.158 (42,5%) nos procedimentos coletivos e 13.723 (57,5%) nos individuais. Constatou-se que a ... (Resumo completo, clicar acesso eletrônico abaixo) Abstract: Auditing system in public health is furthermost important, as it permits the evaluation of veracity of information and to access the accuracy in delivering services, assuming a model of adequate attention. The research objectives were to analyze auditing activities in oral health from the Single Health System within the municipality of Aquidauana (MS); to find the main justifications for glosses and losses in production; and to analyze activities developed by the strategic family health units. This is an epidemiological study of a retrospective historical series, with a quantitative approach, from 2001 to 2010, with a documental analysis and literature review about the auditing systems and the role of the auditor in odontological services. To compile the data from production, losses in procedures, and justifications for glosses as well as the achievement of targets, the database DATASUS was used, reports from the municipal system of auditing in the municipality of Aquidauana (MS) and reports and indicators from decrees 11,684/2004 and 12,005/2005 from the Health State Office of Mato Grosso do Sul- which establishes a minimum of 10 home visits monthly, 26 treatments completed and one education activity. Results show a broad range of activities from the auditing system in the system management, including activities for control, evaluation, supervision, orientation, and guarantee for social engagement and access to services. In this period there were 921,300 odontological procedures; from which 223,226 (24.2%) were individual procedures and 698,074 (75.8%) were collective procedures. There were 23,881 glosses (2.6%), from which 10,158 (42.5%) happened in collective procedures and 13,723 (57.5%) happened in individual procedures. It was found that the most frequent cause for glosses in individual procedures was the repetition in procedure to the ... (Complete abstract click electronic access below) Mestre

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Kim, MyungJoo. "Service-learning's impact on dental students' attitude to community service." Thesis, University of Iowa, 2012. https://ir.uiowa.edu/etd/3324.

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This study is aimed to evaluate service-learning program's impact on senior dental students' attitude to community service at Virginia Commonwealth University (VCU) School of Dentistry. Experience gained through service-learning in dental school may positively impact dental students' attitude to community service that will eventually lead into providing care to the underserved. Two surveys were administered to 105 senior dental students. For the first survey (post-test), students reported their attitude to community service after the service-learning program completion. For the second survey (pre-test), students reported their attitude prior to the program retrospectively. Seventy six students responded to the post-test and fifty six students responded to the pre-test. A repeated-measure mixed-model analysis indicated that overall there was a change between pre-test and post-test. Scales of connectedness, normative helping behavior, benefits, career benefits, and intention showed a significant pre-test and post-test difference. A relationship between attitude to community service and student characteristics such as age, gender, ethnicity, and volunteer activity was also examined. Only ethnicity showed a significant difference. In conclusion, service-learning program at VCU School of Dentistry has positively impacted senior dental students' attitude to community service.

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Jessani, Abbas Ali. "Self-reported oral health and dental service utilization of vulnerable pregnant women registering for the prenatal public health program in Fraser Health, BC, Canada." Thesis, University of British Columbia, 2014. http://hdl.handle.net/2429/46132.

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Objective: To determine the baseline self-reported oral health and dental service utilization of pregnant women from diverse ethno cultural backgrounds within the geographical are of the Fraser Health Authority in British Columbia, Canada. Method: A prospective 34-item cross-sectional survey was administered to all the women enrolling for a prenatal registration program between October 2012 and January 2013. For data analysis, a two-sample t-test was used, and categorical variables were tested using a chi-square test. Multivariable logistic regressions were used to estimate the odds ratio. Results: A total of 740 pregnant women filled out the questionnaire. The majority (84%) of the respondents rated their oral health as good or excellent. Fifty two percent of the women had visited dental professional during last year. Almost 1/3 of those reporting symptoms of depression rated their oral health as fair or poor. Forty-one percent reported having bleeding gums, 22% experienced tooth sensitivity, and 13% had persistent dry mouth since the beginning of their pregnancy. When asked about the beliefs associated with pregnancy, 37% of the respondents expected bleeding gums, and 34% expected tooth sensitivity. Women born in India had visited a dental professional 2.8 times more often than women who had been born elsewhere. Those with dental insurance were 6.6 times more likely to visit a dentist than those without insurance. Conclusion: The majority of pregnant women considered dental care during pregnancy to be very important and had previously visited a dental professional within the last year. However, more than 1/3 had experienced one or more oral problems while more than half held false beliefs about the effects of pregnancy upon oral health. These reported oral beliefs and problems could be addressed with patient education during routine pre-natal care and subsequent referral to a dentist if needed.

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Khalfe, Abdulrasheed Dawood. "A comparative analysis of delivering different modes of dental care at district level." Thesis, University of the Western Cape, 1995. http://etd.uwc.ac.za/index.php?module=etd&amp.

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The aim of this study is to analyse and compare the delivery of oral health care services based on the prevailing curative paradigm and WHO-treatment norms for the school-going community of Mitchells Palin district in relation to selected alternative methods of dental care delivery. The optimal use of auxiliary personnel, purchasing care from private dental practitioners and intriducing water fluoridation was examined.

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Hashim, Raghad, and n/a. "A quantitative and qualitative study of early childhood caries among young children in the Emirate of Ajman, United Arab Emirates." University of Otago. School of Dentistry, 2008. http://adt.otago.ac.nz./public/adt-NZDU20080521.144521.

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Objectives: The objective of the quantitative research was to estimate the prevalence of Early Childhood Caries (ECC) and severe Early Childhood Caries (s-ECC) and the severity of Early Childhood Caries (ECC) in the primary dentition of young children in Ajman, UAE, and investigate their association with child and family characteristics, dietary habits, fluoride use, oral hygiene practices and dental services utilization. The purpose of the qualitative research was to obtain information that could explain some of the findings of the quantitative stage in order to progress towards determining a strategy to control ECC in this population. Methods: A two-stage cluster sample was used to randomly select children aged 5 or 6 years old who were enrolled in public or private schools in Ajman, UAE. Clinical examinations for caries were conducted by a single examiner using WHO criteria. Parents completed questionnaires seeking information on child and family characteristics, dietary habits, oral hygiene, fluoride use and dental service utilization. Bivariate and multivariate analyses were used to identify risk markers and risk indicators for caries experience. To complement the quantitative findings, the second (qualitative) stage of the research was conducted with six chosen groups of mothers from different educational backgrounds and different nationalities. Each group contained between six and ten mothers - some of whose children had been examined in the quantitative section of the project. The mothers were invited to comment on the significance for them of those risk indicators identified in the earlier section of the research. The manual thematic coding method of analysis was used. Problems concerning the dental health of children were identified based on the results of both stages. Results: The total number of children sampled was 1297. Dental examination and questionnaire data were obtained for 1036 (79.9%), of whom 50.0% were female. The prevalence of ECC in 5- and 6-year-old children was 72.9% (95% CI, 61.8, 83.9) and 80.0% (95% CI, 76.0, 84.4) respectively, with mean dmft scores of 4.0 (sd, 4.1) and 4.9 (sd, 4.3) respectively (P<0.05). The overall prevalence of s-ECC was 31.1% (95% CI, 23.6, 38.9). Multivariate analysis indicated that frequency of snacking between meals per day, snack consumption level and the frequency of brushing had a significant effect on the severity of ECC, while only the snack consumption level and the frequency of brushing had a significant effect on plaque score. There was a strong association between plaque score and the severity of ECC. The total number of mothers who contributed to the qualitative study was 42. The findings of the qualitative stage showed that some mothers had a negative perception toward the primary dentition and unhelpful attitudes towards their children�s diets (through promoting a high consumption of cariogenic food), while the use of fluoride (other than in toothpaste) was rare. However, many mothers were in favor of bottled water fluoridation once they understood the benefits of such a scheme and supported the idea of a dental preventive program beng provided through their children�s schools. Conclusions: The prevalence and severity of ECC in young children in Ajman is high, with child and family characteristics, dietary habits, oral hygiene practices and dental utilization being important determinants. Young children in Ajman would benefit from health promotion strategies directed towards appropriate dietary practices and oral hygiene measures framed within culturally specific guidelines.

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Claas, Bianca Muriel. "Self-reported oral health and access to dental care among pregnant women in Wellington : a thesis presented in fulfilment of the requirements for the degree of Master of Public Health at Massey University, Wellington, New Zealand." Massey University, 2009. http://hdl.handle.net/10179/1205.

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Pregnancy can have important effects on oral health and pregnant women are a population group requiring special attention with regard to their oral health and their babies? health. International research shows that oral health care for pregnant women has been inadequate, especially in relation to education and health promotion and there is some evidence of disparities by SES and ethnicity. Improving oral health is one of the health priorities in the New Zealand Health Strategy (Ministry of Health, 2000) and the Ministry of Health (Ministry of Health, 2006a) has recently identified a need for more information on the oral health and behaviour of pre-natal women. The aims of this study were to gain an understanding of pregnant women?s oral health care practices, access to oral health care information and use of dental care services and to identify any difference by ethnicity and socio-economic position. A self-reported questionnaire was completed by 405 pregnant women (55% response rate) who attended antenatal classes in the Wellington region. The questionnaire was broadly divided into four parts: (1) care of the teeth when the woman was not pregnant; (2) care of the teeth and diet during the pregnancy; (3) sources of oral health information during pregnancy and; (4) demographic information . Data were analysed by age, ethnicity, education and income and odds ratios (OR) and 95% confidence intervals (95%CI) were calculated using logistic regression. The majority of women in this survey were pakeha (80.2%), compared to 19.7% „Others? (8.8% Maori, 1.9% Pacific, 8.6% other). Most of the subjects were aged 31-35 years (34.5%), of high SES (household income and education level). Half of the women reported having regular visits to the dentist previous pregnancy while a significant percentage of women saw a dentist basically when they had problems. The usual dental hygiene habits were maintained during pregnancy. However, during pregnancy more than 60% of women reported bleeding gums. Just 32% of women went to see the dentist during pregnancy and less than half had access to oral health information related to pregnancy. „Others? (OR 0.38, 95% CI 0.15-0.91) and low income (OR 0.27, 95% CI 0.10-0.76) groups were significantly less likely to report access to oral health information compared to pakeha and high income groups (respectively). Women who went to see the dentist during pregnancy were more likely to receive information on dental health. However, low income women were more likely to report the need to see a dentist (OR 2.55, CI 1.08-5.99). Information on dental health and access to oral care should be prioritised to low income women, Maori, Pacific and other ethnic groups. Little attention has previously been given to oral health for pregnant women in New Zealand and there is a need to increase awareness of the importance of this area amongst health practitioners particularly Lead Maternity Carers and Plunket and tamariki ora nurses.

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Ayach, Carlos [UNESP]. "Sistema de auditoria no SUS: análise dos dados de produção e glosas no serviço odontológico na rede pública." Universidade Estadual Paulista (UNESP), 2011. http://hdl.handle.net/11449/95398.

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Made available in DSpace on 2014-06-11T19:27:45Z (GMT). No. of bitstreams: 0 Previous issue date: 2011-02-14Bitstream added on 2014-06-13T19:35:53Z : No. of bitstreams: 1 aych_c_me_araca.pdf: 1102238 bytes, checksum: 39ecdde677c4bb89c50094d91a1d2eb4 (MD5) O Sistema de Auditoria no setor saúde é fundamental, pois permite a avaliação da veracidade das informações e a resolubilidade da prestação de serviços, pressupondo o desenvolvimento de um modelo de atenção adequado. Nesta pesquisa, objetivou-se analisar as atividades da auditoria no Sistema Único de Saúde no serviço de saúde bucal do município de Aquidauana (MS); fazer o levantamento das principais justificativas de glosas e das perdas de produção; analisar as atividades desenvolvidas pelas equipes da Estratégia da Saúde da Família. É um estudo epidemiológico de série histórica retrospectiva, com abordagem quantitativa, entre os anos de 2001 a 2010. Foi realizada análise documental e revisão bibliográfica sobre os sistemas de auditoria e o papel do auditor no serviço odontológico. Para o levantamento dos dados de produção, perdas, justificativas de glosas e cumprimento de metas foram utilizadas respectivamente, o sistema de informação do DATASUS, relatórios realizados pelo Sistema Municipal de Auditoria do município de Aquidauana (MS), relatórios dos indicadores propostos pelos Decretos nº 11.684/2004 e nº 12.005/2005 da Secretaria Estadual de Saúde do Mato Grosso do Sul que estabelece mensalmente o mínimo de 10 visitas domiciliares, 26 tratamentos completados e uma atividade educativa. Os resultados mostraram que a atuação da auditoria é abrangente no gerenciamento do sistema, consistindo no controle, avaliação, supervisão e orientação, bem como na garantia da participação social e acesso aos serviços. Neste período foram apresentados 921.300 procedimentos odontológicos; sendo 223.226 (24,2%) procedimentos individuais e 698.074 (75,8%) coletivos. Ocorreram 23.881 glosas (2,6%), sendo 10.158 (42,5%) nos procedimentos coletivos e 13.723 (57,5%) nos individuais. Constatou-se que a... Auditing system in public health is furthermost important, as it permits the evaluation of veracity of information and to access the accuracy in delivering services, assuming a model of adequate attention. The research objectives were to analyze auditing activities in oral health from the Single Health System within the municipality of Aquidauana (MS); to find the main justifications for glosses and losses in production; and to analyze activities developed by the strategic family health units. This is an epidemiological study of a retrospective historical series, with a quantitative approach, from 2001 to 2010, with a documental analysis and literature review about the auditing systems and the role of the auditor in odontological services. To compile the data from production, losses in procedures, and justifications for glosses as well as the achievement of targets, the database DATASUS was used, reports from the municipal system of auditing in the municipality of Aquidauana (MS) and reports and indicators from decrees 11,684/2004 and 12,005/2005 from the Health State Office of Mato Grosso do Sul- which establishes a minimum of 10 home visits monthly, 26 treatments completed and one education activity. Results show a broad range of activities from the auditing system in the system management, including activities for control, evaluation, supervision, orientation, and guarantee for social engagement and access to services. In this period there were 921,300 odontological procedures; from which 223,226 (24.2%) were individual procedures and 698,074 (75.8%) were collective procedures. There were 23,881 glosses (2.6%), from which 10,158 (42.5%) happened in collective procedures and 13,723 (57.5%) happened in individual procedures. It was found that the most frequent cause for glosses in individual procedures was the repetition in procedure to the ... (Complete abstract click electronic access below)

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Garcia, Sanchez Carolina. "Investigation on Time Spent on Caries Prevention in Västerbotten Public Dental Service Clinics : A secondary analysis of data from a longitudinal caries study." Thesis, Uppsala universitet, Internationell mödra- och barnhälsovård (IMCH), 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-391674.

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Introduction: Despite being preventable, dental caries is the most widespread noncommunicable disease (NCD) globally. Being de most prevalent condition, and the attempts of dentists and dental auxiliaries to give oral health the right attention, transparent, reliable, and up-to-date data about the type and level of oral health care costs are of significant societal relevance to present feedback about health system–level efficiency. Methods: Using records from a prospective cohort of 452 12-year-old children from 14 Västerbotten Public Dental Service Clinics an investigation on time spent on caries prevention was done. Time spend on caries prevention per patient per year was used as a proxy for caries prevention costs to understand variation in values in these cohort. Result: Time spend on caries prevention was associated with individual caries experience, clinics caries prevalence and number of dentists and dental auxiliaries in a 1:2 ratio. Besides,the patient’s caries risk assessment could not explain oral health professionals time spent oncaries prevention. Discussion: Time spent on caries prevention was not evenly distributed (median= 6.8 minutes). As a consequence of improved dental health and scarce resources it has been essential to optimize the efficiency in the dental service. Thus, the amount of individualized preventive intervention offered and given by dentists, hygienists and nurses, to the patients in the various risk groups needs to be further clarified.

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Strandberg, Oskar, and Ahmed Azzawi. "Community-based clinical teaching set in a Swedish public dental service – Students and mentors perception regarding their experience." Thesis, Malmö högskola, Odontologiska fakulteten (OD), 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-19613.

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Introduktion: Under den tionde terminen av tandläkarprogrammet på Malmö högskola genomgår studenterna verksamhetsförlagd utbildning (VFU) sedan 2004. Detta sker i samarbete med Folktandvården Skåne och under 15 veckor arbetar studenterna en dag i veckan under handledning på folktandvårdens kliniker i närliggande område.Syfte: Att utvärdera erfarenheter efter genomgången VFU ur deltagarnas perspektiv.Metod: Alla tandläkarstudenter och handledare som genomgått VFU 2006 och 2015 tillfrågades om att besvara en utvärderingsenkät med numerisk bedömningsskala och utrymme för tillhörande kommentarer. Sex studenter och fem handledare som genomgått VFU år 2015 intervjuades även med en semistrukturerad intervjumetodik som sammanfördes genom en tematiserad innehållsanalys. Resultat: Enkät: Poängsättningen var genomgående hög för både 2006 och 2015. Studenterna poängsatte påstående 6 ”Det nuvarande upplägget med 15 veckor och en dags tjänstgöring i veckan är tillfredställande.” signifikant högre 2015 än 2006. Påstående 8 ”Det finns en samsyn avseende metoder och behandlingsval mellan skola och folktandvård.” poängsatte studenterna signifikant lägre än handledarna 2015. 2006 poängsatte studenterna påstående tre ”Sammansättningen av patienter var bra.” signifikant lägre än vad handledarna gjorde. Intervju: Studenter och handledare ansåg att VFU är fördelaktigt i utbildningssyfte och ger studenterna självsäkerhet och trygghet i ansvarstagande. Förslag på förbättringar förekom även under intervjuerna.Slutsats: Verksamhetsförlagd utbildning ger fördelaktigheter både för studenter och deras handledare. Studenter och handledare uttrycker uppskattning och är generellt nöjda efter VFU. Introduction: The tenth semester of the dentistry program at Malmö university students undergoes an outreach program (internship) since 2004 and this is in collaboration with Folktandvården Skåne. During 15 weeks the students work at their assigned clinics one day a week under supervision from their tutors.Objective: To evaluate experiences after placement from the participants' perspective.Method: All dental students and tutors who have completed internship in 2006 and 2015 were asked to answer an evaluation questionnaire with numeric rating scale and scope for comments. Six students and five mentors who have completed internship in 2015 were interviewed with a semi-structured interview methodology, later analysed by content analysis method.Results: Questionnaire: rating was consistently high for both 2006 and 2015. The students scored significantly higher on question six “The set-up of one day of clinical work over 15 weeks were satisfying.” 2015 than in 2006. Students scored question eight“There is a consensus regarding methods and treatment options between the dental school and Folktandvården Skåne” significantly lower than their supervisors in 2015. In 2006 students scored question three “The composition of patients was good” significantly lower than the supervisors did. Interview: Students and tutors felt that the internship had been beneficial for training purposes, giving the students more self-esteem and confidence in taking responsibility. Improvements for the outreach program where proposed. Conclusion: The clinical training program is favourable, both for the students and their tutors. In general terms, the students and the supervisors were satisfied with the cooperation.

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Middlebrooks, Jenna A. "Trends in Early Childhood Caries Rates in the Nashville Area Indian Health Services Tribes." Digital Commons @ East Tennessee State University, 2015. https://dc.etsu.edu/etd/2607.

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Dental caries is the most common chronic disease in children, and prevalence rates are disproportionately higher in American Indian/Alaska Native (AI/AN) populations. The Association of State and Territorial Dental Directors (ASTDD) recommends annual oral health screening for children in Head Start programs using the Basic Screening Survey (BSS). The 2014 study was a follow-up to a 2010 national survey of AI/AN children ages five and under that assessed oral health outcomes such as untreated decay, decay experience, urgent need for treatment, presence of sealants and decayed, missing and filled deciduous teeth (dmft) scores, and investigated the changes in Early Childhood Caries (ECC) prevalence from 2010 to 2014 in the Indian Health Service (IHS) Nashville Area. A gap analysis was completed comparing current recommended practices among dental clinics that participated in the IHS ECC Collaborative ASTDD Framework to Prevent and Control Childhood Tooth Decay (ASTDD Framework). Due to historical mistreatment of AI/AN populations in research, and out of respect for the sovereignty of the Tribal Nations that participated in the study, there limited data was made available for this study. In 2010, 579 children were screened in the Nashville Area; 1231 children participated in 2014. While there was a statistically significant, yet clinically small 9.36% reduction of untreated decay from 2010 (30.33%) to 2014 (27.49%), the ECC Collaborative did not reach their objective of a 25% reduction. There was also a significant increase in urgent need for treatment (3.17% in 2010 to 4.35% in 2014), and in presence of sealants (4.54% in 2010 to 10.01% in 2014). Gaps in best practices identified were related to need for increased risk assessments and enhancing policy development. Based on study findings and the limited access to data on Tribal and Area levels, development of culturally appropriate policies that are unique to individual Tribal needs, and focus on perinatal care, is recommended. Individual Tribal programs also need to be evaluated and surveillance needs to be continued to establish trend data. All program evaluations and research should be conducted in an ethical manner that is community-based and considerate of the needs of the Tribe.

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Palència, Fernàndez Laia. "Socioeconomic inequalities in the use of health care services in Europe : the role of public coverage and population-based cancer screening programmes." Doctoral thesis, Universitat Pompeu Fabra, 2012. http://hdl.handle.net/10803/104154.

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The aim of this thesis was to describe inequalities in the use of different health care services according to socioeconomic position (SEP) in Catalonia, Spain and Europe. In addition, we intended to assess whether the public coverage of the services, in particular dental health care, has an influence on the magnitude of inequalities in the use of such services. Finally, we aimed to determine the influence of population-based female cancer screening programmes on the prevalence of screening and on the extent of inequality. To accomplish these objectives four studies were carried out. The sources of information of the four studies were, respectively: several editions of the Catalan Health general practitioner (GP) services are equitable or manual classes use them to a greater extent. However, there are marked SEP inequalities in the use of outpatient specialist services, especially in dental care. Socioeconomic inequalities in use of dental care services exist throughout Europe, but they are larger in countries in which dental care is not covered at all by the public health care system than in countries in which dental care is partially covered. In Europe, socioeconomic inequalities in breast and cervical cancer screening are not found in countries with population-based screening programmes but they are found in those countries with only regional or pilot programmes and in those countries with opportunistic screening. L'objectiu d'aquesta tesi era descriure les desigualtats en l'ús de diferents serveis sanitaris segons la posició socioeconòmica a Catalunya, Espanya i a Europa. A més a més, es volia avaluar si la cobertura pública dels serveis, en particular la dels serveis dentals, infuencia la magnitud de les desigualtats socioeconòmiques en l'ús d'aquests serveis. Finalment, es va voler determinar la influència dels programes poblacionals de cribratge dels càncers de mama i cèrvix en la prevalença de cribratge i en la magnitud de les desigualtats. Per tal d'assolir aquests objectius es van dur a terme 4 estudis. Les fonts d'informació d'aquests estudis van ser, respectivament: diferents edicions de l'Enquesta de Salut de Catalunya (ESCA), diferents edicions de l'Enquesta Nacional de Salut d'Espanya (ENS), l'Enquesta de Salut, Envelliment i Jubilació a Europa (SHARE) 2006 i dades dels països europeus que van participar a l'Enquesta Mundial de la Salut de l'OMS l'any 2002. Els dos primers estudis eren estudis de tendències mentre que els dos últims van ser transversals. En tots els estudis les desigualtats socioeconòmiques es van mesurar mitjançant índexos relatius (RII) i absoluts (SII) de desigualtat. Els resultats d'aquests estudis mostren que a Catalunya i a Espanya els serveis d'atenció primària són equitatius o fins i tot les persones de classes manuals en presenten una major proporció d'ús. Tanmateix, hi ha marcades desigualtats en visites a l'especialista, en especial en les visites al dentista. Les desigualtats socioeconòmiques en la utilització dels serveis dentals existeixen a tota Europa, però són més grans en aquells països on l'atenció dental no està coberta pel sistema públic de salut que en aquells països on aquesta està parcialment coberta. A Europa, no es troben desigualtats socioeconòmiques en el cribratge dels càncers de mama i cèrvix en aquells països amb programes poblacionals de cribratge, però sí que es troben en aquells països amb programes pilot o regionals o amb només cribratge oportunista.

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Manfredini, Marco Antonio. "Saúde bucal na perspectiva de usuários do Sistema Único de Saúde na cidade de São Paulo no início do século XXI." Universidade de São Paulo, 2011. http://www.teses.usp.br/teses/disponiveis/6/6135/tde-02032011-081852/.

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RESUMO Introdução - O acesso à assistência odontológica pública é um dos principais problemas na área de saúde bucal. Nesta tese, se discute se os cuidados em saúde bucal são sentidos como necessidade por lideranças de movimentos populares de saúde e como estas lidam com o tema, aborda-se o potencial do capital social como referência teórica para analisar essa questão e apresenta-se um quadro da assistência odontológica na cidade de São Paulo. Objetivo - Analisar as representações sociais sobre saúde bucal e controle social entre lideranças da União de Movimentos Populares de Saúde de São Paulo (UMPS). Método - Pesquisa qualitativa, com orientação analítico-descritiva, mediante realização de grupos focais com lideranças da União de Movimentos Populares de Saúde de São Paulo (UMPS). Para a organização e apresentação dos dados, foi utilizado o procedimento metodológico do Discurso do Sujeito Coletivo (DSC). Além disso, fez-se revisão bibliográfica sobre capital social em periódicos brasileiros e utilizaram-se dados secundários para compor o quadro da assistência odontológica na capital paulista. Resultados O processo saúde-doença foi reconhecido como socialmente determinado. Em relação ao entendimento de saúde bucal como necessidade, houve antagonismo. A associação de saúde bucal à saúde geral foi apontada como razão de necessidade. A não identificação da saúde bucal como prioridade foi atribuída à população, aos fatores econômicos, aos governos e à falta de vinculação entre saúde bucal e saúde geral. O princípio da universalização na saúde bucal gerou discursos contraditórios, com forte presença da ideia de que a assistência odontológica deve ser dirigida para as crianças, com a presença de cirurgiões-dentistas nas escolas. As lideranças apontam que a assistência odontológica pública é insuficiente para garantir o acesso; não é resolutiva; tem problemas de infra-estrutura; e dispõe de profissionais que não atendem às exigências da comunidade. A organização da população é condição necessária para a implantação e manutenção de serviços assistenciais, por parte do Estado. Há um forte componente do conceito de saúde enquanto direito de cidadania, e de que a luta política e social é um vetor para a organização de redes assistenciais. Em relação à especificidade da saúde bucal no controle social, emergiram falas contraditórias. Os estudos realizados no Brasil corroboram a ambigüidade conceitual, dificuldade de operacionalização e aferição do conceito de capital social. Sobre a assistência odontológica na cidade de São Paulo registra-se, entre 2000 e 2009, um crescimento expressivo no número de beneficiários de planos odontológicos, que se elevou de cerca de 660 mil para aproximadamente 1,97 milhão, com a cobertura se expandindo de 6,3por cento para 17,9por cento da população paulistana. Por outro lado, é precário o acesso aos serviços públicos. Os indicadores Cobertura de Primeira Consulta Odontológica Programática e Cobertura Populacional Potencial registraram 3,8por cento e 8,2por cento em 2009. Conclusão As representações sociais das lideranças indicam sua visão de mundo e de sua inserção social, destacando-se a condição subalterna com que conseguem influenciar, em algum grau, o processo de decisões sobre as políticas públicas de interesse para a saúde. O capital social não se configura como referencial teórico suficientemente potente para a compreensão das contradições relacionadas à saúde bucal na cidade. Os serviços públicos odontológicos cobrem menos de 10por cento da população, expande-se a cobertura dos planos odontológicos (18por cento ) e se reproduz a transformação dos cuidados odontológicos em mercadorias, acessíveis apenas aos que podem comprá-la no mercado em saúde ABSTRACT Introduction - Access to public dental care is a major problem in the field of oral health. In this thesis, it is discussed whether the oral health care is considered as a need for popular health movement leadership and how they deal with the topic, it is also discussed the potential of social capital as a theoretical reference for analyzing this issue and presents a picture of dental care in São Paulo. Objective - To analyze the social representations of oral health and social control among leadership of the Union of Popular Movements of Health of São Paulo (UMPS). Method - Qualitative research analytical-descriptive-oriented, by conducting focus groups with leadership of the Union of Popular Movements of Health of São Paulo (UMPS). For the organization and presentation of data, we used the methodological procedure of the Collective Subject Discourse (CSD). In addition, we reviewed the literature on social capital in Brazilian periodicals and secondary data was used to compose the picture of dental care in the state capital. Results - The health-disease process was recognized as socially determined. In relation to the understanding of oral health as a necessity, there was antagonism. The association among oral health to general health was cited as reason of need. The failure on prioritizing oral health was most appointed to the population, economic factors, governments and the lack of linkage among oral health and general health. The principle of universalization in oral health has generated contradictory discourses, with a strong presence of the idea that dental care should be directed toward children, with the presence of dentists in schools. The leadership points out that public dental care are insufficient to ensure access, it is not resolving, it has problems of infrastructure, and have professionals who do not meet the requirements of the community. The organization of the population is a prerequisite for the deployment and maintenance of healthcare services by the state. There is a strong component about the concept of health as a right of citizenship, and that the political and social struggle is a vector for the organization of health care networks. In relation to the specific oral health in social control, contradictory statements emerged. Studies conducted in Brazil reinforce the conceptual ambiguity, difficulty in operationalizing and measuring the concept of social capital. Dental care in São Paulo enroll between 2000 and 2009, significant growth in the number of dental plan, which amounted to about 660,000 to about 1.97 million, with coverage expanding from 6.3per cent to 17.9per cent of the population in Sao Paulo. On the other hand, the access to public services is poor. The indicators Coverage of First Outpatient Dental Program and Population Potential Coverage recorded 3.8per cent and 8.2per cent in 2009. Conclusion Leaderships social representation indicate their global vision and their social integration, emphasizing the subordinate status that can influence, to some degree, the decision process on public policies related to health. Social capital is not configured as a theoretical powerful enough to understand the contradictions related to oral health in the city. Public dental services cover less than 10per cent of the population expands the coverage of dental plans (18per cent) and reproduces the changing of dental care in goods, accessible only to those who can buy it on the health market

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Yao, Xiaoxi. "Do Long Work Hours Impede Workers’ Ability to Obtain Health Services?" The Ohio State University, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=osu1405356729.

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Skersytė, Ingrida. "Kauno aukštųjų mokyklų studentų nuomonė apie odontologinių paslaugų prieinamumą." Master's thesis, Lithuanian Academic Libraries Network (LABT), 2012. http://vddb.laba.lt/obj/LT-eLABa-0001:E.02~2012~D_20120605_081643-95578.

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Darbo tikslas. Ištirti Lietuvos sveikatos mokslų universiteto, Kauno technologijos universiteto bei Vytauto Didžiojo universiteto studentų nuomonę apie odontologinių paslaugų prieinamumą. Tyrimo metodika. Tyrime dalyvavo trijų Kauno aukštųjų mokyklų atsitiktinai atrinkti bakalauro nuolatinių studijų studentai. Išdalinta 360 anketų, gauti 347 atsakymai (96,4%). Po 33% atsakytų studentų anketų buvo iš Lietuvos sveikatos mokslų bei Vytauto Didžiojo universitetų, o 34% anketų buvo iš Kauno technologijos universiteto. Vertinta, kaip atsakymai priklausė nuo skirtingų universitetų studentų, jų lyties, odontologinio kabineto rūšies. Skirtumas laikytas reikšmingas, kai p<0,05. Rezultatai. Odontologinių paslaugų prieinamumas, studentų nuomone, organizaciniu, finansiniu bei komunikaciniu požiūriu yra geras. Studentams atvykti pas gydytoją labiausiai trukdo jų pačių laiko trūkumas (72,9%). Žvelgiant iš finansinės pusės: retai (40%) arba dažnai (38%) finansinių problemų turi beveik vienoda dalis studentų. Organizacinį prieinamumą respondentai taip pat įvertino neblogai. Beveik pusė apklaustųjų (47,3%) dantis gydosi privačioje praktikoje ir dažniausiai lankosi dėl dantų gydymo (52,2%). Telefonu registruojasi dauguma (73,2%) apklaustųjų. Vizito pas odontologą 48,4% tenka laukti 1 – 2 savaites ir dauguma (49%) dažniausiai patenka laiku, nebent reikia palaukti iki 15 min. (74,9%). Vizitas pas odontologą trunka 31 – 60 min. (49,6%). Daugumos respondentų nuomone (70,3%), odontologų... [toliau žr. visą tekstą] Aim of the Study. Surveying Lithuanian University of Health Sciences, Kaunas Technology University and Vytautas Magnus University students’ opinion on dental service accessibility. Survey methods. The selected at random B.A. students of three Kaunas universities took part in the survey. 360 questionnaire forms were given out to the students and 347 answers were received (96. 4%). Lithuanian University of Health Sciences students as well as Vytautas Magnus University students presented 33% of the answers and Kaunas Technology University – 34%. It was estimated how the answers depended on different university students, their sex and the type of dental surgery. The difference was considered important when p<0,05. Results. In students’ opinion the dental service accessibility is good from organizational, financial and communicative point of view. 72.9 % of the students say they can not get to the doctor mainly due to their lack of time. Financial problems arise to almost the same number of students: rarely – 40%, often – 38%. The respondents estimated organizational accessibility quite well. Nearly a half of the surveyed (47.3%) go to private dental surgeries to have their teeth treated (52.2% in most cases). 73.2% of the respondents make appointments by telephone. 48.4% of the surveyed have to wait for 1-2 weeks to get an appointment and the majority (49%) are accepted at the appointed time, unless it is necessary to wait for up to 15 min. (74.9%). The visit at the dentist... [to full text]

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Machado, Geovanna de Castro Morais. "Urgência odontológica na primeira infância: perfil do atendimento das Unidades de Saúde de Urgência da Secretaria Municipal de Saúde de Goiânia." Universidade Federal de Goiás, 2013. http://repositorio.bc.ufg.br/tede/handle/tede/3713.

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Submitted by Erika Demachki (erikademachki@gmail.com) on 2014-12-01T17:01:44Z No. of bitstreams: 2 Dissertação - Geovanna de Castro Morais Machado - 2013.pdf: 1533306 bytes, checksum: e16ca58206af7c3cd308d7a6b59f61f9 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Approved for entry into archive by Erika Demachki (erikademachki@gmail.com) on 2014-12-01T17:02:04Z (GMT) No. of bitstreams: 2 Dissertação - Geovanna de Castro Morais Machado - 2013.pdf: 1533306 bytes, checksum: e16ca58206af7c3cd308d7a6b59f61f9 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Made available in DSpace on 2014-12-01T17:02:04Z (GMT). No. of bitstreams: 2 Dissertação - Geovanna de Castro Morais Machado - 2013.pdf: 1533306 bytes, checksum: e16ca58206af7c3cd308d7a6b59f61f9 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Previous issue date: 2013-02-26 Aim: The aim of this study was to describe how the community centers from the the city of Goiania handled dental emergency care in children under 6 years during 2011. Methods: This quantitative study evaluated the dental charts of children under 6 years old of age focusing on emergent dental care and assessed dental emergency risk classification, child’s age and gender, chief complaint, involved teeth, clinical procedures performed, medications prescribed and referral. Data were recorded on forms for later descriptive analysis. Results: 1,108 children under 6 years old (4.0%) were treated, 556 male (50.2%), with a mean age of 3.7 years old (±1.4). The most reported chief complaints were toothache (47.9%, n=531) and dental trauma (20.0%, n=221). The most frequently performed clinical procedures were extraction (13.0%) and endodontic treatment (13.0%). No clinical procedures were performed in 58.5% of the cases (n=649). Conclusion: Emergency dental care for children under 6 years occurs mainly as a result of dental decay. It is necessary that emergency dental public services have a more effective management of these situations. Objetivo: O objetivo desse estudo foi verificar o perfil do atendimento das urgências odontológicas em crianças menores de 6 anos nas Unidades de Saúde de Urgência da Secretaria Municipal de Saúde de Goiânia-Goiás. Material e Métodos: Neste estudo descritivo, foram analisadas as fichas de crianças menores de 6 anos atendidas nestes serviços de urgência, entre os meses de janeiro e dezembro de 2011. Foram observados: classificação de risco, idade e sexo da criança, queixa principal, procedimentos executados, dentes acometidos, prescrição de medicamentos e encaminhamentos. Resultados: Foram atendidas 1108 crianças menores de 6 anos (4.0% do total de atendimentos nos serviços de urgência), sendo que 556 eram meninos (50,2%). A idade média das crianças foi de 3,7 anos (DP ±1,4). As queixas mais descritas foram dor de dente (47,9%, n=531) e trauma dentário (20,0%, n=221). Os procedimentos clínicos mais executados foram a exodontia (13,0%) e intervenção pulpar (13,0%). Em 58,5% (n=649) dos casos de urgência não houve realização de procedimento clínico local. Conclusão: A urgência odontológica em crianças menores de 6 anos ocorre, principalmente, como consequência da cárie dentária. Os serviços públicos voltados à urgência/emergência em saúde necessitam de um manejo mais efetivo dessas situações.

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Nilsson, Anna, and Paulina Johansson. "Upplevd arbetssituation hos tandhygienister inom folktandvård och privat tandvård : en jämförande studie." Thesis, Kristianstad University, School of Health and Society, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:hkr:diva-6635.

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Syftet med studien var att jämföra den upplevda arbetssituationen hos tandhygienister inom folktandvården med tandhygienister inom den privata tandvården. Tandhygienister i södra Sverige som var registrerade hos SRAT (n=313) tillfrågades att delta i studien. Enkäten skickades ut elektroniskt, vilket gav en svarsfrekvens på 48% (n=151). Inom folktandvården svarade 59% (n=101) och inom den privata tandvården svarade 35% (n=50). Enkätfrågorna omfattade arbete, arbetsklimat, arbetssituation, profession, hälsa, inflytande och stöd i yrkesrollen samt bakgrundsfrågor om ålder, kön, anställningsform och arbetstid. Resultaten visade statistiskt signifikanta skillnader (p<0,05) mellan tandhygienister inom folktandvården och tandhygienister inom den privata tandvården gällande i vilken utsträckning de styrde över sina tidsbokningar, upplevde trötthet, orolighet, besvär från rygg, nacke eller axlar samt besvär från andra delar av kroppen. En statistisk signifikant skillnad (p<0,01) mellan tandhygienister inom folktandvården och tandhygienister inom den privata tandvården syntes även i vilken utsträckning respondenterna styrde över sin arbetstakt. Slutsatsen av studiens begränsade material är att tandhygienisterna inom den privata tandvården tycktes ha en mer positiv syn på deras arbetssituation än tandhygienisterna inom folktandvården. The aim of this study was to compare the perceived work situation among dental hygienists in the public dental health service with dental hygienists in private practice. Dental hygienists in southern Sweden who were registered at SRAT (n= 313) were asked to participate in the study. The questionnaire was sent out electronically, which gave a response rate of 48% (n= 151). The response rate in the public dental health sevice was 59% (n= 101) and in private practice 35% (n=50). The survey questions covered work, work atmosphere, work situation, profession, health, influence and collegial support together with background questions about age, gender, employment status and working hours. The result showed a statistically significant difference (p<0.05) between the dental hygienists in the public dental health service and dental hygienists in private practice as regards to what extent the dental hygienists decided over their own scheduled time, experienced tiredness, worry, disorders from the back, neck or shoulders and disorders from other parts of the body. A statistically significant difference (p<0.01) between the dental hygienists in the public dental health service and the dental hygienists in private practice was also shown as regards to what extent the dental hygienists could control their own work pace. The conclusion from the limited material of this study is that the dental hygienists in private practice seemed to have a more positive view of their work situation compared to the dental hygienists in the public dental health service.

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Soares, Fabíola Fernandes. "O processo de trabalho da Pesquisa Nacional de Saúde Bucal (SBBrasil 2010): percepção dos coordenadores." Universidade Federal de Goiás, 2014. http://repositorio.bc.ufg.br/tede/handle/tede/4582.

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Submitted by Erika Demachki (erikademachki@gmail.com) on 2015-05-25T12:44:16Z No. of bitstreams: 2 Dissertação - Fabíola Fernandes Soares - 2014.pdf: 3584352 bytes, checksum: aca80ae0a8b50961c03163659eea2b96 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Approved for entry into archive by Erika Demachki (erikademachki@gmail.com) on 2015-05-25T12:46:13Z (GMT) No. of bitstreams: 2 Dissertação - Fabíola Fernandes Soares - 2014.pdf: 3584352 bytes, checksum: aca80ae0a8b50961c03163659eea2b96 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Made available in DSpace on 2015-05-25T12:46:13Z (GMT). No. of bitstreams: 2 Dissertação - Fabíola Fernandes Soares - 2014.pdf: 3584352 bytes, checksum: aca80ae0a8b50961c03163659eea2b96 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Previous issue date: 2014-08-29 Fundação de Amparo à Pesquisa do Estado de Goiás - FAPEG The work process involved in population health surveys may interfere with the quality of generated information, which might be useful for population health surveillance analysis and decision making. Despite surveys being considered important to evaluation, there is only an incipient literature concerning the assessment of epidemiological surveys´ work process. This cross-sectional study, employing quantitative and qualitative approaches, aimed to assess the perception of the 2010 Brazilian Oral Health Survey (SBBrasil 2010) coordinators of the survey´s work process. An electronic semi-structured questionnaire was sent to all SBBrasil 2010 coordinators (N=213). The investigated variables were grouped into the following topics: respondents´ characteristics, role during the survey, qualification, operational aspects, interpersonal relationship, financial aid, advertisement, work experience, usefulness of the survey, self-assessment, future oral health surveys´ participation, and suggestions for future surveys. Response rate was of 75.6% (N=161). Most respondents were dentists (90%), aged between 30 and 49 years, females (68%), in management position (75.8%), permanent workers at the public health system (59.2%) and acted as municipal coordinators of the survey (77.6%). Reported positive aspects of the survey were: planning, training and calibration workshops, logistic support provided by both the health system and the surveys´ coordination, good relationship between staff, and survey acceptability by the participants selected for the sample and by the health professionals. The transport allowance/financial aid, the perception of inconsistency between the allowance granted and the delay in payment were considered negative aspects. The respondents reported the SBBrasil 2010 experience as useful to train staff to perform data collection and showed interest in participating in future oral health surveys. Of the seventeen aspects studied, only three were identified as shortcomings of the SBBrasil 2010's work process: the transport allowance, isolated cases of conflict between staff and conflict between members of the coordination. All of the other aspects were mainly facilitators of the work process. The most frequently cited suggestion for future surveys was changes in methods (34.4%), followed by general issues related to the conduction of the survey (31.1%) and also higher pay (23.3%). It is concluded that the perception of the coordinators of the National Oral Health Survey (SBBrasil 2010) of the work process studied was mainly positive. The results may contribute to the improvement of the health professionals´ work process in future oral health surveys. O processo de trabalho em inquéritos de saúde pode interferir na qualidade das informações produzidas, que posteriormente são utilizadas tanto na análise da vigilância em saúde de uma população como na tomada de decisões. Apesar do reconhecimento da importância atribuída à avaliação, a literatura se mostra incipiente em estudos que analisem o processo de trabalho na pesquisa epidemiológica. Este estudo tem como objetivo identificar a percepção dos coordenadores da Pesquisa Nacional de Saúde Bucal (SBBrasil 2010) sobre o processo de trabalho realizado. Trata-se de um estudo transversal, com abordagem quanti-qualitativa, utilizando um questionário eletrônico semiestruturado, que foi enviado para os indivíduos que atuaram como coordenadores do SBBrasil 2010 (n=213). As variáveis pesquisadas foram agrupadas nos seguintes eixos temáticos: características dos participantes, função exercida na pesquisa, qualificação, aspectos operacionais, relacionamento interpessoal, ajuda de custo, divulgação, experiência profissional, utilidade da pesquisa, autoavaliação, participação em futuros inquéritos de saúde bucal e sugestões para futuros levantamentos. A taxa de resposta foi de 75,6% (n= 161). A maior parte dos respondentes eram cirurgiões-dentistas (90%), entre 30 a 49 anos, do sexo feminino (68%), em cargo de gestão no serviço público (75,8%), com vínculo efetivo (59,2%) e desempenhou a função de coordenador municipal na pesquisa (77,6%). Os pontos positivos relatados foram: as oficinas de planejamento, de treinamento e calibração; o apoio logístico tanto do serviço quanto da coordenação da pesquisa; o bom relacionamento entre os membros da equipe e a aceitação da pesquisa pelos indivíduos selecionados para a amostra e pelos profissionais envolvidos. O custeio para deslocamento inerente à pesquisa, a percepção de incoerência do valor de custo recebido e o atraso no seu pagamento foram considerados pontos negativos a serem superados. A maioria dos coordenadores relataram que a experiência do SBBrasil 2010 serviu para qualificar a equipe de campo na coleta de dados e manifestaram interesse em participar de futuros inquéritos em saúde bucal. Dos dezessete aspectos estudados, apenas três foram apontados como dificultadores do processo de trabalho no SBBrasil 2010: ajuda de custo para deslocamento, alguns casos isolados de conflito com a equipe e de conflito com algum outro membro da coordenação. Os demais aspectos foram predominantemente assinalados como facilitadores do processo de trabalho. Dentre as sugestões apontadas para futuros levantamentos, mudanças na metodologia (34,4%) foi a mais citada pelos coordenadores, seguida por aspectos gerais relacionados à realização da pesquisa (31,1%) e por melhor remuneração (23,3%). Conclui-se que a percepção dos coordenadores da Pesquisa Nacional de Saúde Bucal (SBBrasil 2010) sobre o processo de trabalho investigado foi predominantemente positiva. Espera-se que os resultados possam contribuir com o aprimoramento do processo de trabalho dos profissionais em futuros levantamentos em saúde bucal.

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Pilotto, Luciane Maria. "Os planos privados de saúde no Brasil e sua influência no uso de serviços de saúde : análise dos dados da PNAD 1998, 2003, 2008 e da PNS 2013." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2016. http://hdl.handle.net/10183/148219.

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O Brasil possui um sistema de saúde com cobertura universal (Sistema Único de Saúde- SUS) defendendo a saúde como um direito de todos os cidadãos e dever do estado. Apesar deste sistema público universal, o sistema de saúde brasileiro é composto por um mix público-privado que favorece cobertura duplicada aos serviços de saúde para a parcela da população com posse de plano privado de saúde. Um quarto dos brasileiros possui plano privado de saúde e, portanto, tem acesso duplicado aos serviços de saúde. A posse de plano privado de saúde e o uso dos serviços médicos e odontológicos precisam ser analisados neste contexto. Os objetivos desta tese são analisar as tendências no uso dos serviços de saúde médicos e odontológicos e verificar sua relação com a posse de planos privados de saúde. Os resultados desta tese estão organizados em dois manuscritos. O primeiro manuscrito “The relationship between private health plans and use of dental and medical health services among Brazilians: a cross-sectional study, 2008” teve por objetivo descrever o uso de serviços de saúde médico e odontológico de acordo com o tipo de serviço utilizado (público, privado ou por plano privado de saúde) e analisar o efeito do cadastro na Estratégia de Saúde da Família (ESF). Neste estudo foram analisados 391.868 indivíduos provenientes do banco da Pesquisa Nacional de Amostra Domiciliar (PNAD) de 2008. Como esperado, indivíduos sem plano privado de saúde utilizaram mais o serviço público, enquanto aqueles com plano utilizaram mais os serviços do seu plano. Ainda, os indivíduos com plano privado de saúde tendem a utilizar mais os serviços de saúde. Por outro lado, estar cadastrado em ESF aumenta o uso do serviço público e reduz o uso do privado e do plano entre os indivíduos sem plano e aumenta a chance de usar qualquer serviço entre aqueles que têm plano. Assim, políticas para a expansão da ESF devem ser incentivadas e a posse de plano privado precisa ser monitorada e regulada para evitar gastos desnecessários em saúde e o aumento das iniqüidades no acesso, principalmente em países com sistema universal de saúde. O segundo manuscrito “Tendências no uso de serviços de saúde médicos e odontológicos e a relação com nível educacional e posse de plano privado de saúde no Brasil, 1998 a 2013” teve como objetivo analisar as tendências no uso de serviços de saúde médico e odontológicos por adultos no Brasil entre 1998 e 2013 em relação à posse de planos privados de saúde e nível educacional. Foram analisados 760.678 indivíduos oriundos dos bancos de dados nacionais da PNAD de 1998, 2003, 2008 e da Pesquisa Nacional de Saúde de 2013. Adultos (18 a 59 anos) com posse de plano privado de saúde apresentaram chance maior de usar os serviços de saúde comparados àqueles sem plano em todos os anos analisados. No entanto, houve tendência de diminuição do uso dos serviços médicos entre indivíduos com posse de plano privado de 1998 para 2013. Em relação ao uso dos serviços odontológicos, o declínio foi observado de 2003 para 2013. O percentual de adultos com plano privado para assistência médica diminuiu de 24,9% para 22,2%, enquanto a tendência de posse de plano exclusivamente odontológico aumentou de 1,0% para 6,3% de 1998 para 2013. Tendência de aumento no uso de serviços de saúde, médico e odontológico, entre adultos sem plano privado de saúde também foi verificada. Acompanhar as tendências na posse de planos privados e no uso dos serviços, bem como avaliar o estado de saúde e o tipo de serviço utilizado (público, pagamento direto do bolso ou através do plano) são necessários para auxiliar o estado na regulação dos planos e evitar o aumento das iniquidades no acesso e uso dos serviços entre os cidadãos. Brazil has a health care system with universal coverage (Unified Health System, or SUS) advocating health as a right to all citizens and a duty of the state. Despite this universal public system, the Brazilian health system is composed of a public-private mix that favors doubled coverage for part of the population with private health plan. About a quarter of Brazilians has private health insurance and therefore has duplicate access to health services. The private health plan possession and the use of medical and dental services need to be analyzed in this context. The objectives of this thesis are to analyze trends in possession of private health plans and verify their relation to the use of medical and dental health services. The results this thesis is organized in two manuscripts. The first manuscript "The relationship between private health plans and use of dental and medical health services among Brazilians: a cross-sectional study, 2008" aimed to describe the use of medical and dental health services according to the type of service used (public, private or private health plan) and assess the effect of being registered in the Family Health Strategy (ESF). This study analyzed 391,868 individuals from the 2008 National Household Survey (PNAD). As expected, individuals without private health plan used more public health services, while those with private health plan tend to use more their plan. Overall, those with private health plan tend to use more the health services. On the other hand, being registered in ESF increased the use of public service and reduced the use of private service among individuals without private health plan, and increased the chance to use any service among those with plan. Thus, policies for expanding ESF should be encouraged and private health plans need to be monitored and regulated to avoid unnecessary expenses on health and increasing inequities in access, especially in countries with universal health systems. The second manuscript " Trends in use of dental and medical services and its association with education and having private health plan in Brazil, 1998 to 2013" aimed to analyze trends in use of medical and dental health services among Brazilian adults between 1998 and 2013 in relation to private health plans and educational level. The sample included 760,678 individuals from the PNAD in the years 1998, 2003, 2008 and the National Health Survey in 2013. Adults (18-59 year-old) with private health plan were more likely to use health services compared to those without a plan in every years analyzed. However, there was a trend of decrease in the use of medical services among adults with private health plan from 1998 to 2013. In relation to the use of dental services, a decrease was observed from 2003 to 2013. The percentage of individuals with medical plans has decreased from 24.9% to 22.2%, while the trend in exclusively dental private plan has increased from 1.0% to 6.3% from 1998 to 2013. Trend the increase to use health services between adults without private health plan was found in medical and dental service. Monitoring trends in the private health plan possession, and health services use, and to assess the health conditions and the type of service used (public, private out-of-pocket or through the plan) are important for the state regulation and to avoid increasing inequities in access and use of health services among citizens.

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Jarutis, Laurynas. "Specializuotų odontologinių paslaugų plėtros galmybių vertinimas Tauragės rajone." Master's thesis, Lithuanian Academic Libraries Network (LABT), 2014. http://vddb.library.lt/obj/LT-eLABa-0001:E.02~2014~D_20140618_233823-88629.

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Darbo tikslas. Ištirti specializuotų odontologinių paslaugų plėtros galimybes Tauragės rajone. Tyrimo uždaviniai. Įvertinti Tauragės rajono gyventojų nuomonę apie specializuotų odontologinių paslaugų poreikį bei bendrosios praktikos gydytojų odontologų požiūrį į specializuotų odontologinų paslaugų plėtros galimybes Tauragės rajone; suformuluoti specializuotų odontologinių paslaugų plėtros Tauragės rajone rekomendacijas. The opportunities for development of specialized dental care services in Tauragė district is a novel and practice-oriented issue. The necessity for management of such services is an integral part of public health management. Collaboration in health care system for favorable development of opportunities is a key task for policy-makers, health professionals, and patients themselves. In order to define patients' and dentists' needs, attitudes, and perspectives it is relevant to substantiate the opportunities for development of dental care services both scientifically and practically. Aim of the study: to assess the opportunities for development of specialized dental care services in Tauragė district. Objectives: to evaluate Tauragė district residents' views on the need for specialized dental care services; to evaluate general practice dentists' views on opportunities for development of specialized dental care services in Tauragė district; to formulate the recommendations for the development of specialized dental care services in Tauragė district. Methods. The questionnaire-based study was a survey of 290 residents of Tauragė district who visited a dentist in Tauragė district during the study period. The data analysis was quantitative using statistical data processing software "SPSS 17.0 for Windows". The indicators were described by means (for continuous variables) and percentages (for dichotomous variables). Statistical hypotheses were tested using chi square test, Spearman... [to full text]

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Edvardsson, Kristina. "Health promotion in pregnancy and early parenthood : the challenge of innovation, implementation and change within the Salut Programme." Doctoral thesis, Umeå universitet, Epidemiologi och global hälsa, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-70172.

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Background: In 2005, the Västerbotten County Council launched a child health promotion programme, “the Salut Programme”, in response to an alarming prevalence of overweight and obesity, and trends of increased dental caries, among young county citizens. The programme, initially developed in four pilot areas, is built on multidisciplinary and cross-sectoral collaboration and aims to support and strengthen health promotion activities in health care, social services and school settings. It targets children and adolescents (0-18 years of age) and their parents, and starts during pregnancy. This thesis focuses on interventions provided by antenatal care, child health care, dental services, and open pre-schools, directed to expectant parents and families with children aged 0-1 ½ years. Within the programme context, the aim was to explore socio-demographic patterns of overweight and obesity in expectant parents (Paper I), firsttime parents’ experiences of health promotion and lifestyle change during pregnancy and early parenthood (Paper II), professionals’ experiences of factors influencing programme implementation and sustainability (Paper III and IV), and early programme outcomes on professionals’ health promotion practices and collaboration following countywide dissemination and implementation (Paper IV). Methods and results: A population based cross-sectional study among expectant parents showed overweight and obesity in 29% of women (pre-pregnancy) and in 53% of men (n=4,352♀, 3,949♂). The likelihood for obesity was higher in expectant parents with lower levels of education, among those unemployed or on sick leave, and those living in rural areas. In 62% of couples, at least one of the partners was overweight or obese; a positive partner correlation was also found for BMI (I). An interview study with 24 first-time parents (n=12♀, 12♂) revealed that they primarily undertook lifestyle changes to secure the health of the fetus in pregnancy, and to provide a healthy environment in childhood. Parents described themselves as highly receptive to information about how their lifestyle could influence fetal health, and they frequently discussed pregnancy risks related to tobacco and alcohol, as well as toxins and infectious agents in foods. However, parents did not seem inclined to make lifestyle changes primarily to promote their own health. The antenatal and child health care services were perceived as being mainly directed towards women, and parents described a lack of a holistic view of the family which included experiences of fathers being treated as less important (II). An interview study undertaken with professionals (n=23) in the Salut Programme pilot areas indicated programme sustainability at most sites, two years after implementation, although less adherence was described within child health care. Factors influencing programme sustainability, as described by professionals, were identified at multiple organisational levels (III). A before-and-after survey among professionals (n=144) measured outcomes of the county-wide implementation of the Salut Programme in 13 out of 15 county municipalities. Results showed significant improvements in professionals’ health promotion practices and collaboration across sectors. A number of important implementation facilitators and barriers, acting at different organizational levels, were also identified via a survey comprised of open-ended questions (IV). Conclusion: The Salut Programme, developed with high involvement of professionals, and strongly integrated in existing organisational structures and practices, shows potential for improving health promotion practices and cross-sectoral collaboration. The findings can inform further development of the Salut Programme.as well as new health promotion initiatives, and inform policy practice and future research. These aspects include approaches in health promotion and prevention, father involvement during pregnancy and early parenthood, and factors influencing implementation and sustainability of cross-sectoral health promotion programmes. Bakgrund: År 2005 lanserade Västerbottens läns landsting en hälsofrämjande satsning “Salut” som svar på en oroande förekomst av övervikt och fetma samt trender till ökad förekomst av karies hos barn i länet. Satsningen, som initialt utvecklades i fyra pilotområden, bygger på tvärprofessionellt och verksamhetsövergripande samarbete och syftar till att stödja och stärka hälsofrämjande insatser inom landstinget och länets kommuner. Satsningen riktar sig till barn och unga (0-18 år) och deras föräldrar, med start under graviditeten. Denna avhandling fokuserar på insatser som erbjuds via mödrahälsovård, barnhälsovård, tandvård och öppen förskola riktade till blivande föräldrar och familjer med barn i åldern 0-1 ½ år. Med utgångspunkt från Salut-satsningen syftar avhandlingen till att undersöka socio-demografiska mönster av övervikt och fetma hos blivande föräldrar (I), förstagångsföräldrars upplevelser av hälsofrämjande insatser och förändrade levnadsvanor under graviditet och tidigt föräldraskap (II), personalens upplevelser av underlättande och hindrande faktorer för satsningens införande och uthållighet (III, IV), samt förändringar i arbetssätt och samarbete mellan verksamheterna efter den länstäckande spridningen av satsningen (IV). Metod och resultat: En populationsbaserad tvärsnittsstudie bland blivande föräldrar visade på övervikt och fetma hos 29% av kvinnorna (vikt före graviditet) och hos 53% av männen (n=4352♀, 3949♂). Lägre utbildningsnivå, arbetslöshet och sjukskrivning samt att bo utanför städerna visade sig öka sannolikheten för fetma. Hos en övervägande del av paren (62%) fanns minst en partner med övervikt eller fetma och samband kunde även påvisas mellan kvinnans och mannens BMI (I). En intervjustudie med 24 förstagångsföräldrar (n=12♀, 12♂) visade att föräldrarna främst förändrade sina levnadsvanor för att säkra hälsan hos fostret under graviditeten och för att skapa en hälsosam miljö för barnet under uppväxten. Föräldrarna beskrev sig själva som mycket mottagliga för information om hur deras levnadsvanor kunde påverka fostrets hälsa och de diskuterade ofta graviditetsrisker i relation till tobak och alkohol samt gifter och smittoämnen i livsmedel. Föräldrarna var dock mindre angelägna att förändra sina levnadsvanor med tanke på sin egen hälsa. De upplevde att mödrahälsovårdens och barnhälsovårdens insatser i huvudsak riktades till kvinnor och beskrev en avsaknad av helhetssyn på familjen, vilket även avspeglades i upplevelser av att papporna behandlades som mindre viktiga (II). En intervjustudie med personal (n=23) inom pilotområdena, två år efter utveckling och införandet av Saluts insatser, indikerade god uthållighet av satsningen, även om en lägre följsamhet till insatserna beskrevs inom barnhälsovården. Faktorer som av personalen beskrevs påverka uthålligheten identifierades på flera organisatoriska nivåer (III). En före- och efterstudie bland personal (n=144) mätte effekter av den länstäckande spridningen av satsningen i 13 av länets 15 kommuner. Resultaten visade på flera signifikanta förbättringar av de hälsofrämjande arbetssätten och ett ökat samarbete mellan verksamheterna. En enkät med öppna frågor riktad till personalen belyste också faktorer på flera organisationsnivåer som ansågs underlätta respektive hindra införandeprocessen (IV). Slutsats: Salut-satsningen, som är utvecklad i nära samarbete med verksamheternas personal och väl integrerad i redan existerande organisatoriska strukturer och arbetssätt, visar på potential att förbättra hälsofrämjande arbetssätt och samarbete mellan verksamheter. Aspekter som beskrivits och diskuterats kan vägleda satsningens fortsatta utveckling såväl som framtida nya initiativ. Resultaten och slutsatserna kan även användas i syfte att påverka policy, praxis och framtida forskning. Detta avser framförallt hälsofrämjande och sjukdomsförebyggande metoder, pappans roll under graviditet och tidigt föräldraskap samt kunskaper om faktorer som kan ha betydelse för genomförande och uthållighet av verksamhetsövergripande hälsofrämjande insatser.

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Berry, Elizabeth. "PREVENTIVE DENTAL SERVICES FOR INFANTS AND SUBSEQUENT UTILIZATION OF DENTAL SERVICES." VCU Scholars Compass, 2009. http://scholarscompass.vcu.edu/etd/1708.

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The purpose of this study was to examine the use of dental services for young children following a preventive oral health intervention in a pediatric medical clinic. Over a 3 year period (2005-2008), children 0-36 months of age, enrolled in Medicaid, were provided preventive oral health services in a medical setting. Descriptive statistics and multivariate logistic regression were used to determine the effect receiving the preventive oral health services in a medical setting with the outcomes of dental utilization. 15% were determined to have dental caries at the intervention and 42% found to have a dental visit post-intervention. Children determined to have decay at the intervention were significantly more likely to have one or more restorative or adjunctive service post-intervention. After receiving preventive oral health care in a medical clinic, the resulting utilization of dental services was higher than what is commonly reported for dental utilization in infant populations of low-income children.

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Kavaliauskienė, Aistė. "Odontologijos paslaugų vaikams kokybė tėvų požiūriu." Master's thesis, Lithuanian Academic Libraries Network (LABT), 2005. http://vddb.library.lt/obj/LT-eLABa-0001:E.02~2005~D_20050530_225219-36201.

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QUALITY EVALUATION OF DENTAL SERVICE FOR CHILDREN FROM THE PARENTS' POINT OF VIEW Aistė Kavaliauskienė Supervisor Antanas Šidlauskas, Assoc. Prof., D.D.S., PhD., Department of Social Medicine, faculty of Public Health, Kaunas University of Medicine. – Kaunas, 2005. �� P.74 Aim of the study – to evaluate the quality of dental services for children from the parents’ point of view. Methods. The anonymous questionnaire survey was performed among 280 parents of children visiting their pediatric dentists or orthodontists in four Kaunas public health care institutions. The research methodology used the questionnaire based upon SERVQUAL instrument. Two sets of questions, one relating to the respondents’ expectations, the other relating to the respondents’ perceptions of a particular aspect of service quality, comprised the questionnaire. The perceived gaps between expectations and perceptions were analysed regarding five service quality dimensions (tangibles, responsiveness, reliability, assurance, empathy). Likert-type scales were used for the evaluation of the examined characteristics. The statistical package SPSS version 11.0 for Windows was used to conduct data analysis. Results. There was a statistically significant difference between the parents’ expectations (mean score 4,31±0,36) compared with their perceptions (mean score 3,86±0,46) of the dental service provided. The largest quality gap was observed in characteristic regarding reliability while the smallest gap concerned... [to full text]

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Costa, Adriana Cristina Oliva [UNESP]. "Percepção do cirurgião-dentista sobre trabalho no Sistema Único de Saúde." Universidade Estadual Paulista (UNESP), 2010. http://hdl.handle.net/11449/104212.

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Made available in DSpace on 2014-06-11T19:33:00Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-08-19Bitstream added on 2014-06-13T21:05:36Z : No. of bitstreams: 1 costa_aco_dr_araca.pdf: 434039 bytes, checksum: 5a80adc9f83140fd3b9d2ea2ecdbf039 (MD5) Avaliar os serviços de saúde é fundamental para garantir a qualidade na prestação de serviços. O objetivo deste estudo foi conhecer as condições de trabalho, relacionadas ao trabalho no Sistema Único de Saúde, por meio da percepção do cirurgião-dentista, avaliando: a satisfação profissional com o emprego público e remuneração, as condições ergonômicas e sanitárias do ambiente de trabalho e a qualidade de vida e saúde dos profissionais relacionadas ao ambiente de trabalho. Realizou-se uma pesquisa transversal, tipo inquérito e observacional. A coleta de dados foi feita por meio de entrevistas com 83 cirurgiões-dentistas, atuantes em 12 municípios paulistas. As informações foram processadas no software Epi Info 2000 versão 3.2.2. As variáveis analisadas foram: tipo de ingresso, regime de trabalho, carga horária, remuneração percebida, existência de plano de carreira, satisfação com o emprego público, aspectos sanitários e ergonômicos relacionados à distribuição de equipamentos no consultório odontológico, presença da auxiliar na equipe, satisfação com o trabalho efetuado e com o ambiente físico odontológico, segurança, saúde, lazer e renda. Os resultados apontam que 19% dos entrevistados não prestaram concurso público para ingressar no sistema público. O regime de trabalho estatutário foi mais adotado 47(57%). Notaram-se jornadas de trabalho distintas: 47(57%) de 20h, 7(8%) de 30h e 29(35%) de 40h. Estavam insatisfeitos com a remuneração 55(66%) profissionais, notando-se, ainda, a ausência do plano de carreira em 11municípios; 70(84%) profissionais afirmaram estar “satisfeito” e “muito satisfeito” com o emprego público. Observou-se que 21(28%) profissionais trabalhavam sozinhos; nos 34 consultórios, autoclave foi o meio mais utilizado 15(44%); 31(91%) lixeiras de lixo comum e 23(68%) de lixo contaminado eram inadequadas; 13(38%)... The evaluation of the health service is fundamental to ensure the quality of the realization of the services. The aim of this study was to examine the working conditions related to the employment at the Brazilian Public health Service, by means of the perception of the Dental Surgeon, evaluating: professional satisfaction with the public employment and remuneration. The sanitary and ergonomic conditions at workplace environment and the quality of life and health of the professionals related to work environment. A cross-sectioned inquiry and observational type study was performed. Data collection was made through interviews, realized on 83 dental surgeons operative in 12 municipalities of the state of Sao Paulo. Information was processed on Epi Info 2000 software, version 3.2.2. The analyzed variables were: type of income, labor regime, workload, perceived remuneration, career plan existence, satisfaction with public employment, sanitary and ergonomic aspects related to the equipment distribution at the dental office, presence of an assistant in the team, satisfaction with realized work and with physical environment, safety, health, leisure and earnings. The results showed that 19% of the interviewed did not apply for public contest to enter the public service. Statutory work regime was the most adopted 47(57%). Different workdays were noticed: 47 (57%) of 20h, 7(8%) of 30h and 29(35%) of 40h; 55(66%) professionals were unsatisfied with the remuneration and, furthermore, the absence of a career plan was observed in 11 municipalities. 70 (84%) professionals affirmed to be “satisfied” and “very satisfied” with public employment. It was observed that 21(28%) professionals worked alone; at the 34 dental offices, autoclave was the most used method 15(44%); 31(91%) common waste bins and 23(68%) bins of contaminated material were inadequate; 13(38%) had no hand washbasins, 23(68%) ...(Complete abstract click electronic access below)

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Gaskin, Elizabeth Bowles. "Knowledge, attitudes, and behaviors of federal service and civilian dentists concerning minimal intervention dentistry." Diss., University of Iowa, 2006. http://ir.uiowa.edu/etd/57.

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Thorson, Rhonda R. "Dunn County comprehensive health assessment Phase II physical and dental health /." Online version, 2002. http://www.uwstout.edu/lib/thesis/2002/2002thorsonr.pdf.

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Oliveira, Deise Cruz. "Minimally invasive dentistry approach in dental public health." Thesis, University of Iowa, 2011. https://ir.uiowa.edu/etd/1047.

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Dental caries is the main reason for placement and replacement of restorations (Keene, 1981). More than 60 percent of dentists' restorative time is spent replacing existing restorations. The replacement of restorations can result in a cavity preparation larger than its predecessor which leads to weakening of the remaining tooth structure (Mjör, 1993). Considering the traditional surgical dental caries management philosophy, it was based on "extension for prevention" and restorative material needs rather than on preserving the healthy tooth structure (Black, 1908). In the 1970s, the surgical dental paradigm began shifting to a new approach for caries management: Minimally Invasive Dentistry (MID). It was based on the medical model that prioritizes caries risk assessment, early caries detection, remineralization of tooth structure, and especially preservation of tooth structure through minimal intervention in the placement and replacement of restorations (Yamaga et al, 1972). The minimal intervention paradigm emphasizes use of adhesive restorative materials in order to minimize the size of cavity preparation (Murdoch-Kinch & McLean, 2003). Hence, a cross-sectional study using an online survey instrument (30-item) was conducted among National Network for Oral Health Access (NNOHA) and American Association Community Dental Programs (AACDP) members. Besides demographics, the survey addressed the following items using a 5-point Likert scale: knowledge, attitudes and behavior concerning MID among general practitioners. Specific questions focused on practitioner and practice characteristics, previous training and knowledge of MID, knowledge use of restorative, diagnostic and preventive techniques and whether MID was considered to meet the standard of care in the U.S., which was the main outcome of the study. Chi-square, Fisher's exact test, Wilcoxon rank-sum test, and two-Sample t-test were used to identify factors associated with beliefs that MID meets the standard of care. Overall, 86% believed MID met the standard of care for primary teeth, and 77% believed this for permanent teeth. The study found that those with more favorable opinions of fluoride to be more likely to believe MID met the standard of care, but no demographic or practice characteristics were associated MID standard of care beliefs.

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Satur, Julie, and julie satur@deakin edu au. "Australian dental policy reform and the use of dental therapists and hygienists." Deakin University. School of Health Sciences, 2002. http://tux.lib.deakin.edu.au./adt-VDU/public/adt-VDU20061207.115552.

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Oral diseases including dental caries and periodontal disease are among the most prevalent and costly diseases in Australia today. Around 5.4% of Australias health dollar is spent on dental services totalling around $2.6 billion, 84% of which are delivered through the private sector (AIHW 2001). The other 16% is spent providing public sector services in varied and inadequate ways. While disease rates among school children have declined significantly in the past 20 years the gains made among children are not flowing on to adult dentitions and our aging population will place increasing demands on an inadequate system into the future (AHMAC 2001). Around 50% of adults do not received regular care and this has implications for widening health inequalities as the greatest burden falls on lower income groups (AIHW DSRU 2001). The National Competition Policy agenda has initiated, Australia-wide, reviews of dental legislation applying to delivery of services by dentists, dental specialists, dental therapists and hygienists and dental technicians and prosthetists. The review of the Victorian Dentists Act 1972, was completed first in 1999, followed by the other Australian states with Queensland, the ACT and the Northern Territory still developing legislation. One of the objectives of the new Victorian Act is to promote access to dental care. This study has grown out of the need to know more about how dental therapists and hygienists might be utilised to achieve this and the legislative frameworks that could enable such roles. This study used qualitative methods to explore dental health policy making associated with strategies that may increase access to dental care using dental therapists and hygienists. The study used a multiple case study design to critically examine the dental policy development process around the Review of the Dentists Act 1972 in Victoria; to assess legislative and regulatory dental policy reforms in other states in Australia and to conduct a comparative analysis of dental health policy as it relates to dental auxiliary practice internationally. Data collection has involved (I) semi-structured interviews with key participants and stakeholders in the policy development processes in Victoria, interstate and overseas, and (ii) analysis of documentary data sources. The study has taken a grounded theory approach whereby theoretical issues that emerged from the Victorian case study were further developed and challenged in the subsequent interstate and international case studies. A component of this study has required the development of indicators in regulatory models for dental hygienists and therapists that will increase access to dental care for the community. These indicators have been used to analyse regulation reform and the likely impacts in each setting. Despite evidence of need, evidence of the effectiveness and efficiency of dental therapists and hygienists, and the National Competition Policy agenda of increasing efficiency, the legislation reviews have mostly produces only minor changes. Results show that almost all Australian states have regulated dental therapists and hygienists in more prescriptive ways than they do dentists. The study has found that dental policy making is still dominated by the views of private practice dentists under elitist models that largely protect dentist authority, autonomy and sovereignty. The influence of dentist professional dominance has meant that governments have been reluctant to make sweeping changes. The study has demonstrated alternative models of regulation for dental therapists and hygienists, which would allow wider utilisation of their skills, more effective use of public sector funding, increased access to services and a grater focus on preventive care. In the light of theses outcomes, there is a need to continue to advocate for changes that will increase the public health focus of oral health care.

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Suominen-Taipale, Anna Liisa. "Demand for oral health care services in adult Finns." Turku : Turun Yliopisto, 2000. http://catalog.hathitrust.org/api/volumes/oclc/45710669.html.

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Mathias, Célia Regina de Jesus Caetano. "A contribuição dos cirurgiões-dentistas para a prevenção e tratamento da cárie em adolescentes nas capitais brasileiras." Universidade do Estado do Rio de Janeiro, 2014. http://www.bdtd.uerj.br/tde_busca/arquivo.php?codArquivo=8563.

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Esta tese é composta por três estudos ecológicos que incluíram as 27 capitais brasileiras. Esses três estudos foram os seguintes: 1- A associação entre a disponibilidade de cirurgiões-dentistas e a quantidade de procedimentos odontológicos nos serviços públicos de odontologia; 2- A associação entre a disponibilidade de cirurgiões-dentistas e a proporção de dentes restaurados (em relação ao total de dentes atacados pela cárie) em indivíduos de 15 a 19 anos ; 3- A associação da disponibilidade de cirurgiões-dentistas com a prevalência e severidade da cárie em indivíduos de 15 a 19 anos. As três investigações são apresentadas sob forma de artigos. Foram utilizados diversos bancos de dados secundários, disponíveis gratuitamente na internet. No primeiro estudo foi identificada associação do número de Equipes de Saúde Bucal do programa Saúde da Família (ESB) e de cirurgiões-dentistas no SUS de uma forma geral com o número de procedimentos odontológicos no serviço público; quanto mais ESB e cirurgiões-dentistas mais procedimentos odontológicos, tanto preventivos quanto restauradores. Mais dentistas no serviço público de odontologia significaram mais procedimentos preventivos e coletivos, porém um número relativamente pequeno a mais de restaurações. É preocupante a quantidade relativamente pequena de restaurações realizadas pelos dentistas do serviço público no Brasil diante do grande número de dentes com cárie não tratada, identificado pela pesquisa nacional de saúde bucal. O segundo estudo revelou que a quantidade de dentistas nas capitais brasileiras é muito grande e que, portanto, há capacidade instalada para atender todas as necessidades de tratamentos restauradores. Entretanto, o índice de cuidado odontológico em jovens de 15 a 19 anos revelou que menos da metade dos dentes atacados pela cárie tinham recebido o cuidado adequado, i.e., estavam restaurados. Este estudo concluiu que, o grande investimento da sociedade brasileira em odontologia, seja no setor público ou privado, não está tendo o retorno esperado, pelo menos para jovens de 15 a 19 anos. O terceiro estudo concluiu que fatores socioeconômicos amplos e flúor na água foram os principais determinantes da variação na prevalência e severidade da cárie em jovens de 15 a 19 anos e que a contribuição do dentista foi relativamente pequena. Diante do papel relativamente pequeno do dentista na prevenção da cárie, o esforço clínico do mesmo deveria, portanto, enfatizar tratamentos de maior complexidade, visando a restauração e reabilitação de danos relevantes para a função e bem estar (Serviço Pessoal de Saúde). Esforços efetivos para evitar a cárie dentária ocorrem principalmente no âmbito de estratégias preventivas populacionais (Serviço não Pessoal de Saúde), com uma contribuição relativamente pequena do trabalho clínico. This thesis comprises three ecological studies including the 27 state capitals. These three studies were as follows: 1- The association between the availability of dentists and the amount of dental procedures in public dental services; 2- The association between the availability of dentists and the proportion of filled teeth (in relation to total teeth attacked by caries) in subjects 15-19 years; 3- The combination of the availability of dentists with the prevalence and severity of dental caries in individuals 15-19 years. The three investigations are presented in the form of articles. Many banks side, available freely on the internet data were used. In the first study association was found in the number of oral health teams of the Family Health Program (ESB) and dentists in the NHS in general with the number of dental procedures in the public service; ESB as more and more dentists dental procedures, both preventive as restorers. "Most dentists" in public dental services meant more collective and preventive procedures, but a relatively small number of the most restorations. Worryingly the relatively small amount of restorations performed by dentists of the public service in Brazil on the number of teeth with untreated caries, identified by a national survey of oral health. The second study revealed that the number of dentists in the Brazilian capital is very large and, therefore, there is capacity to meet all the needs of restorative treatments. However, the rate of dental care for young people aged 15 to 19 years revealed that less than half of the teeth attacked by caries had received proper care, for example, were restored. This study concluded that the large investment in Brazilian society in dentistry, whether in the public or private sector, is not having the expected return, at least for young people 15-19 years. The third study found that larger socioeconomic factors and fluoride in the water was the major determinant of variation in the prevalence and severity of dental caries in young people 15-19 years and that the contribution of the dentist was relatively small. Given the relatively small role of dental caries prevention, clinical effort it should therefore emphasize more complex treatments, aimed at the restoration and rehabilitation of significant damage to the function and well-being ("Personal Health Service"). Effective efforts to prevent tooth decay occur primarily in population-based prevention strategies ("no Personal Health Service"), with a relatively small contribution of clinical work.

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Rashid-Kandvani, Farnaz. "Access to dental services for people using a wheelchair." Thesis, McGill University, 2013. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=119688.

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Studies show that people with disabilities, including people using a wheelchair, have more untreated dental problems and tend to use dental services less than the rest of the population. Despite this discrepancy, the nature of these difficulties and the shape of their dental care pathways have not been studied. Consequently, this study was undertaken to address this gap, with the goal of better understanding the difficulties that people using a wheelchair experience in accessing dental services and to identify solutions to facilitate their access to quality dental services. This research was structured to effectively study and advocate for possible solutions to this problem. It is based on a participative approach, culminating from the many partnerships we developed with people with physical disabilities, dental professionals, and dental educators. These partners formed an advisory committee that provided advice and direction during various stages of the project. Furthermore, we adopted a qualitative descriptive research design: a particularly appropriate way of exploring phenomena about which very little is known. Through a purposeful sampling strategy, we recruited 13 adults living in Montreal. All of the participants used a wheelchair because of various mobility impairments. We conducted a semi-structured individual interview with each of them and analyzed transcripts using an inductive thematic method. The resulting interviews illustrate that people with physical disabilities face a wide range of barriers in accessing dental services. These difficulties were classified into 11 challenges faced throughout the dental care pathway. These challenges begin with the tasks of finding an accessible dentist, being accepted by the dentist as a patient, and organizing the appointment and its related transportation. After overcoming these challenges, people using a wheelchair can experience further difficulties entering the building, moving inside the clinic, and interacting with the staff. Moreover, additional difficulties occur during treatment sessions: transferring into the dental chair may be difficult or sometimes impossible; once in the dental chair, people may experience physical pain, muscular spasms or other uncomfortable sensations. Time may also be an issue as sessions may last longer than expected. Finally, financial barriers related to the cost of dental treatment proved to be a recurrent concern. Overall, our study conclusively shows that people using a wheelchair face discrimination in accessing dental services. The challenges we identified culminate in the creation of oral health inequalities as some people with physical disabilities eventually give up using these ill-adapted services. We firmly believe that it is the responsibility of any given society to remove the existing barriers that are faced by people using a wheelchair. Accordingly, this study provides a series of recommendations that will initiate and maintain this change. These recommendations are targeted at multiple sectors of society, including the government, the dental profession, dental faculties, and organizations that represent people with physical disabilities. Les études montrent que les personnes à mobilité réduite ont plus souvent des problèmes dentaires non traités que le reste de la population; en outre, elles ont tendance à moins utiliser les services dentaires. Malgré cette situation problématique, on connait très mal le parcours thérapeutique des personnes à mobilité réduite et les difficultés que ces dernières rencontrent dans l'accès aux services. La présente étude a été entreprise pour remédier à cette lacune. Notre but était de mieux comprendre les difficultés que les personnes utilisant un fauteuil roulant rencontrent dans l'accès aux services de soins dentaires, et d'identifier des solutions pour remédier à leurs problèmes. Cette recherche est basée sur une approche participative, et sur des partenariats avec des personnes à mobilité réduite, des professionnels dentaires et des éducateurs dentaires. Ces partenaires ont formé un comité consultatif qui nous a conseillé lors des différentes étapes du projet. En outre, nous avons adopté une méthodologie de recherche qualitative descriptive, approche qui est particulièrement appropriée pour explorer les phénomènes dont on sait très peu. Grâce à une stratégie d'échantillonnage ciblé, nous avons recruté 13 adultes vivant à Montréal. Tous les participants utilisaient un fauteuil roulant en raison de divers problèmes de mobilité. Nous avons effectué une entrevue individuelle semi-structurée avec chacun d'eux et analysé les transcriptions en utilisant une méthode thématique inductive. Les entrevues révèlent que les personnes à mobilité réduite rencontrent de multiples barrières dans l'accès aux services dentaires. Celles-ci ont été classées en 11 difficultés rencontrées dans leur parcours de soins dentaires. Elles débutent avec le défi de trouver un dentiste accessible, d'être accepté par le dentiste, d'organiser le rendez-vous et le transport. Après avoir surmonté ces défis, les personnes utilisant un fauteuil roulant peuvent éprouver des difficultés supplémentaires pour entrer dans le bâtiment, se déplacer à l'intérieur de la clinique, et interagir avec le personnel. En outre, des difficultés se produisent pendant les séances de traitement: être transféré dans le fauteuil dentaire peut être difficile ou parfois impossible; une fois dans le fauteuil dentaire, les gens peuvent éprouver des douleurs physiques, des spasmes musculaires ou d'autres sensations désagréables; le temps peut également être un problème car les sessions durent souvent plus longtemps que pour les autres personnes. Enfin, les obstacles financiers liés au coût des traitements dentaires s'avèrent des préoccupations récurrentes. Globalement, notre étude montre que les personnes utilisant un fauteuil roulant sont victimes de discrimination dans l'accès aux services dentaires. Les défis que nous avons identifiés peuvent générer des inégalités de santé buccodentaire si les personnes avec un handicap physique renoncent aux services des professionnels dentaires. Nous croyons fermement qu'il est de la responsabilité de la société de supprimer les multiples obstacles auxquels font face les personnes utilisant un fauteuil roulant. Par conséquent, la présente étude propose une série de recommandations qui s'adressent à plusieurs secteurs de la société: le gouvernement, la profession dentaire, les facultés dentaires et les organisations qui représentent les personnes à mobilité réduite.

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Tane, Helen Rose, and n/a. "The role of the dental therapist in New Zealand's public health system." University of Otago. Dunedin School of Medicine, 2004. http://adt.otago.ac.nz./public/adt-NZDU20070507.114703.

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This study examines aspects of how dental therapy began and developed, since it was introduced as one of the first public health occupations in New Zealand, in 1921. Dental therapy began as dental nursing, and was introduced by visionary dentists in order to treat widespread dental disease within the New Zealand population. The occupation gained international recognition. Dental nurses performed their tasks under the direct supervision and direction of a public health dentist and the occupation was restricted to females and child-patients. Investigating issues that have influenced the development of dental therapy is critical in today�s climate. Background research in the thesis reveals an interplay of issues relating to gender, professional development and measures of how successful the occupation has been in relation to oral health need. The latter is particularly questionable for our indigenous people in New Zealand. How has the role of the dental therapist in New Zealand been utilised? Has the delivery of care been based on sound knowledge and dental need? Has the role progressed in order to provide effective and appropriate care within a publicly funded system? These issues are important issues, particularly when New Zealand�s dental therapy profession becomes one of the many health professions that will be affected by the new Health Practitioners Competence Assurance Act when it is implented over the following year. In order to improve oral health for the population, it is vital that the dental therapist is appropriately and effectively utilised. How oral health workers perceive the past role and future role in achieving oral health gain is investigated in this study by using interviews and postal surveys, and the results are discussed. The findings show that the dental therapist has not always been utilised and developed using sound epidemiological evidence. Elements of professional protection by the dental profession coupled with depleted health funding rather than dental need have appeared as driving factors. Furthermore, the dental therapy profession has remained in a sub-ordinate role to the dental profession. The findings of this study show that a large number of the current dental therapy workforce do not feel that they are ready to provide dental care autonomously. Information in the thesis argues that past legislation and subordination to the dental profession has largely affected the development of dental therapy, and whether this has always assisted in improving oral health for the New Zealand population is questioned in this work. With a depleted number in the workforce, the role has become focussed on a reparative form of care, not one that promotes and improves oral health. This is not acceptable in a publicly funded system. Implementing changes to the dental therapy role must be undertaken, but undertaken with caution and based on progressive health-promoting ideology.

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Momen, Jennifer. "The Association between Early Dental Visits, Dental Outcomes, and Oral Health-Related Quality of Life in West Virginia Children." Thesis, West Virginia University, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=10110159.

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Background and objectives: Early dental visits provide the opportunity to reduce the prevalence of early childhood caries through risk assessment, counseling, and provision of specific preventive measures. Despite the American Academy of Pediatric Dentistry’s recommendation that the first dental visit should occur by 1 year of age, many children are not receiving care until much later. Evidence that early dental visits improve dental outcomes is vital to educate parents and health care providers. Hence, this study examined the association between a child’s age at the first dental visit and dental outcomes, parents’ awareness of the recommendation for the first dental visit, and perceived barriers to dental care. A secondary aim examined pediatric dentists’ perceived barriers to children’s early dental care in West Virginia. Methods: A cross-sectional survey was used to collect data from parents of children ≤ 6 years of age, and under the care of a pediatric dentist. Pearson correlation was used to examine the association between age at first dental visit and age at caries onset. Chi-square analyses were used to test the association between (1) age at first dental visit and history of caries, (2) age at first dental visit and history of an adverse dental outcome, and (3) reason for the first dental visit and history of an adverse dental outcome. A binary logistic regression model was used to evaluate the extent to which age at the first dental visit explained caries history. For the qualitative study component, pediatric dentists responded to questions regarding barriers to the establishment of a dental home for West Virginia children. Results: A significant association was noted between a child’s age at the first dental visit and age at caries onset, r (29) = 0.65, p <.0001 [95% CI=0.39, 0.82]. No significant association was noted between age at the first dental visit and history of caries, or between age at first visit and history of adverse outcome (p >.05). However, children whose first visit was for a problem with the teeth or mouth were significantly more likely to have had an adverse outcome, χ2 (1, n = 160) = 7.60, p = .0058. The adjusted odds ratio for age at first dental visit in the logistic regression model predicting caries history was 1.10, [95% CI= 1.04, 1.17], p =.0013. Pediatric dentists perceived the limited dental workforce in West Virginia to be the greatest barrier to early dental visits for children. Conclusions: This pilot study demonstrates that parent reported dental outcomes may be useful in studies evaluating the association between early dental visits and dental outcomes. There remains a need to educate parents about the recommended first dental visit by age 1 year.

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Whittle, J. G. "Developing dental services for the elderly mentally ill." Thesis, University of Manchester, 1985. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.374576.

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Marshall, Keith Francis. "Standards and quality assessment in general dental practice." Thesis, King's College London (University of London), 1995. https://kclpure.kcl.ac.uk/portal/en/theses/standards-and-quality-assessment-in-general-dental-practice(8481398c-b8bf-438d-b96b-ab3d5f8d4083).html.

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Aljawad, Ayman. "Dental public health implications of novelty sweets consumption in children." Thesis, Cardiff University, 2016. http://orca.cf.ac.uk/91950/.

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Statement of problem: The expansion of the novelty sweets market in the UK has major potential public health implications for children and young adults as they may cause dental erosion, dental caries and obesity. Aims and objective: To investigate the potential dental public health implications of novelty sweet consumption in children. The objectives of this study were to determine the available novelty sweets available to UK consumers, to determine the erosive potential of the most available novelty sweets, to establish the sensory thresholds in children and to determine any potential link between high sensory threshold individuals and their consumption of novelty sweets. Methodology: A list of the most commonly available novelty sweets was created by undertaking scoping visits of shops in the Cardiff area. Children’s use and knowledge of the ten most available novelty sweets were undertaken using focus groups, amongst 11-16 year old children. The focus groups informed the design of a questionnaire. The questionnaire was distributed to 46 children aged 11-16 years during a sensory analysis assessment involving sensory taste thresholds for sweet and sour, assessed using the intensity ranking method. The pH of the ten most available novelty sweets was assessed using an electronic pH meter; the neutralisable acidity was measured by titration against 0.1M sodium hydroxide; an erosion test was conducted on human teeth using a surfometer; contact angles were measured using a Dynamic Contact Angle Analyser; the viscosity was measured using a rotational viscometer and sugar content of the sweets was measured using a refractometer. Results: A wide range of novelty sweets were available, accessible to children in 73% of shops with an average price of 96p. The children were all familiar with novelty sweets, they reported buying and consuming them regularly. The majority of children (65%) required higher amounts of sugar and citric acid than the absolute taste threshold to recognise the sweet and sour tastes. There was an inverse relationship between the preference of the novelty sweets and perception of sweet and sour sensory thresholds (p < 0.05). The pH of eight of the ten novelty sweets was significantly lower than the orange juice (p < 0.05). The neutralisable acidity of seven of the sweets was significantly higher than the orange juice (p < 0.05). The erosive potential of six novelty sweets was significantly higher than the erosive potential of the orange juice (p < 0.05). Delayed ultrasonication by 1 h, reduced the amount of subsurface enamel loss by 0.52-1.45μm in presence of saliva. Some of the acidic solutions had low contact angles, lower viscosity and higher sugar content than orange juice. Conclusions: A wide range of acidic and free sugar sweetened novelty sweets were easily accessible and affordable to children. Children reported consuming these sweets regularly. The high sensory taste thresholds perception for sweet and sour in children may potentially affect their consumption of novelty sweets. Those personnel involved in delivering dental and wider health education or health promotion need to be aware of and able to advise on current trends in sweet confectionary. The potential effects of these novelty sweets on both general and dental health require further investigation.

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Dong, Mei 1966. "Oral health beliefs and dental health care-seeking behaviors among Chinese immigrants." Thesis, McGill University, 2006. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=101114.

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Understanding culturally related health values and identifying ethnically specific health seeking pathways can help health care providers supply culturally competent services and enhance cooperation with patients of different backgrounds. Cultural competency training, notably through cultural awareness courses, promotes understanding of the impact of social factors on illness and thus prepares medical and dental students to better serve their patients. Cultural awareness can also help preventive health programs fit community needs and cultural contexts. Despite the fact that Chinese immigrants are the fastest growing ethnic minority in North America, few studies have been published on their beliefs and health-seeking behaviours following immigration. We thus lack information on how Chinese immigrants regard dental health and manage their dental problems. Objective. The aims of this study were to explore how oral illness is viewed by Chinese immigrants in Montreal, Canada and how they manage dental problems. Methods. We conducted a qualitative research study based on semi-structured, one-on-one interviews and thematic analyses of the transcribed interviews. Twelve adult Montreal Chinese immigrants with a high level of education participated in the study. Results. Chinese immigrants in Montreal have a good understanding of dental caries in terms of its etiology, process, and ways to prevent and treat it. It thus seems that there is no major cultural barrier between this type of immigrant and oral health care professionals in regard to dental caries. However, we also observed that traditional beliefs and medications coexist with scientific dental knowledge and professional treatments concerning problems such as gingival swelling, gingival bleeding, and bad breath. In the case of gingival swelling, for instance, participants identified etiological factors that referred to both cultures: local factors referred to oral hygiene and were related to scientific culture, whereas general factors referred to traditional knowledge ("internal fire"). Chinese immigrants' dental health seeking pathways include self-treatment, consulting a dentist in Canada or in China during a return visit, and obtaining Chinese traditional medicine. The dental health seeking pathways varied depending on the circumstances. For dental caries and other acute diseases such as toothache, Chinese immigrants prefer to consult a dentist. For chronic diseases, some of them rely on self-treatment or an alter-native treatment such as traditional Chinese medicine. The language barrier, financial problems and lack of trust are the main factors affecting Chinese immigrants' access to dental care services in Canada. Former bad medical or dental experience among Chinese immigrants causes a loss of trust in Western medicine and dentistry and influences the decision to seek alternative treatments. Conclusion. This study suggests that, in order to facilitate dentist-patient communication; oral health professionals should be informed of immigrants' representation of oral health and illness, and that Chinese immigrants should be provided with basic scientific knowledge.

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Van, Wyk Candice. "Trends in dental caries prevalence and severity in South Africa." Pretoria : [s.n.], 2007. http://upetd.up.ac.za/thesis/available/etd-08222008-172346/.

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李存榮. "城市口腔衞生服務需要、需求和利用的研究 : 以上海口腔衞生服務的發展為例". Thesis, University of Macau, 2004. http://umaclib3.umac.mo/record=b1636890.

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Antunes, Denise Silveira. "Assessment of a framework for the allocation of primary dental services." University of the Western Cape, 2017. http://hdl.handle.net/11394/5603.

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Philosophiae Doctor - PhD Background: Standardized and evidence-based resource allocation frameworks for timely provision of primary dental services may support equitable distribution of comprehensive dental care. However, such frameworks, which can be applicable to primary care settings in Brazil, are not available. The purpose of this study was to explore the complex issue of equity allocation of dental staff for primary dental care services, by estimating time to dental disease progression in order to analyze costs when survival targets are set for patients waiting for primary dental care. The inclusion of wait time benchmarks for dental services in the design of the framework was an attempt to increase knowledge on the quality of access experienced by people living within catchment areas of the Family Health Strategy in Brazil. In view of ever scarce resources for public health services, ethical dilemmas arise in resource allocation when allocation choices require priority setting among individuals who face similar health needs. Since equity of access must be assured for all Brazilian citizens, the present study proposed a rational resource allocation model to help decision-makers in reconciling equity access and budgets. Aim: This study aimed to compare equity of access to dental services and costs of dental staff of two models for primary care settings. Additionally, staffing requirements and staff costs were projected over a three-year time period. Both models comprised three inter-related components: (i) universal access to oral health care, (ii) comprehensiveness of primary dental care and (iii) equity of access to primary dental services. Method: The present study was part empirical and part modeling in design. In the empirical phase, a set of maximum wait times for dental care determined by experts (Model 1) vs. wait times derived from survival analysis (Model 2) was compared. A one-year follow-up of a cohort of dental patients assigned to five primary health care clinics was conducted. The event of interest was clinical deterioration in the waiting time for dental visits. At each consultation with a dentist either for routine or emergency reasons, the oral quadrants of the patient were assessed and classified according to their urgency for dental care (from 1, less urgent to 5, more urgent). In the modeling phase, costs of dental staff were estimated on the basis of survival probabilities found in Model 1 and on survival targets simulated in Model 2. The amount of staff required as calculated by combining data on: dental service needs, activity standards for dental services, workload components in dental care, cost per working hour of dental staff, and probabilities of clinical deterioration in the wait for dental visits. Main Findings: In Model 1 (wait times determined by experts), survival probabilities were found to be unevenly distributed between diagnostic categories: category 4= 0.939 (SE 0.019); category 3= 0.829 (SE 0.035); category 2= 0.351 (SE 0.061) and category 1= 0.120 (SE 0.044). The cost of dental staff in Model 1 was estimated to be R$104 110.88 (BRL). In cost simulations of Model 2, where wait times were derived from the survival analysis study, a similar 0.900 survival probability target for all sampled quadrants (n=7 376) was found regardless of their final classification in the study year. The resulting cost of Model 2 was R$99 305.89 (BRL). Conclusions: From an equity-access perspective, the survival analysis concluded that wait times for dental visits determined by the experts may engender inequitable survival probabilities for oral quadrants classified in different diagnostic categories. From a dental-staff costs perspective, one concluded that less resources were required by setting an equitable 90% survival target for all oral quadrants studied.

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