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Resumen: La orientación emprendedora es crucial para que los agricultores desempeñen su actividad económica con mayor crecimiento. El entorno institucional y la colaboración juegan un papel importante para desarrollar habilidades de emprendimiento. El objetivo de este estudio fue determinar el efecto mediador de las redes de colaboración en la relación de los pilares institucionales y la orientación emprendedora de los campesinos. Se tomó como base la teoría neoinstitucional, la teoría del capital social y la teoría de los recursos y capacidades. Se hizo un estudio empírico con base en un modelo de ecuaciones estructurales. Se realizó un levantamiento de información con 192 productores agrícolas localizados en el estado de Aguascalientes. En la postura emprendedora, la proactividad fue más importante que arriesgarse o ser más innovador para abarcar con mayor profundidad el mercado. La mediación de las redes de colaboración entre los agricultores ayuda con los costos de las regulaciones, el desconocimiento del entorno institucional y la administración de la actividad agrícola.

Abstract: Entrepreneurial orientation is crucial for farmers to carry out their economic activity with greater growth. The institutional environment and collaboration play an important role in de veloping entrepreneurial skills. The objective of this study was to determine the mediating effect of collaboration networks in the relationship between institutional pillars and the entrepreneurial orientation of peasants. The neoinstitutional theory, the theory of social capital and the theory of resources and capabilities are taken as a theoretical basis. It is an empirical study based on a structural equation model. An information survey was carried out with 192 agricultural producers located in the state of Aguascalientes. Relevant results were obtained on the involvement of the entrepreneurial stance, taking into account that the dimension of proactivity is more important than taking risks or being more innovative to cover the market in greater depth. An important finding was that the mediation of collaborative networks between farmers helps lower the costs of regulations and overcome the lack of knowledge about the institutional context and agricultural activity management.

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OBJECTIVE: To analyze prenatal and perinatal stressors associated with molar incisor hypomineralization (MIH) in adolescents. METHODS: Prospective cohort study collected prenatal (socioeconomic status, maternal age, number of prenatal visits, smoking, obesity during pregnancy, abortion history, gestational hypertension) and perinatal stressors (type of delivery, gestational age, birth weight, intensive care unit-ICU at birth). The outcome was MIH at 18-19 years follow-up (n = 590). MIH was defined according to the Ghanim criteria - Model I. We performed a sensitivity analysis, including opacities demarcated in index tooth, incisive or molars, Model II. Through structural equation modeling, we analyzed direct and mediating pathways between multiple stressors with outcomes. RESULTS: MIH was observed in 15.25% (n = 90), and opacities demarcated in any index tooth were observed in 22.8% of adolescents (n = 135). In Model I, no stressor explained MIH significantly, although we watched high standardized coefficients (SC) for low birth weight (SC = 0.223, p = 0.147), lower gestational age (SC = 0.351; p = 0.254), and ICU admission (SC = 0.447, p = 0.254). In Model II, advanced maternal age (SC = 0.148; p < 0.05) and not undergoing prenatal care (SC = 0.384, p < 0.03) explained opacities demarcated in incisors or molars. CONCLUSION: Advanced maternal age and not undergoing prenatal care were associated with MIH lesion-like in incisors or molars.

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BACKGROUND: Oral health needs assessment is important for oral health care planning. This study compared dental treatment needs between normative and sociodental needs. We also longitudinally examined the relationships of baseline sociodental needs measures and socioeconomic status with one-year follow up measures of use of dental services, dental caries, filled teeth, and oral health-related quality of life (OHRQoL). METHODS: A prospective study was conducted with 12-year-old adolescents from public schools in deprived communities in the city of Manaus, Brazil. Validated questionnaires were used to collect adolescents' sex and socioeconomic status, OHRQoL (CPQ11 - 14) and behaviours (sugar intake, frequency of toothbrushing, regular use of fluoridated toothpaste and pattern of dental attendance). Normative need was assessed according to decayed teeth, clinical consequences of untreated dental caries, malocclusion, dental trauma, and dental calculus. The relationships between variables were tested thorough Structural equation modelling. RESULTS: Overall 95.5% of adolescents had normative dental treatment needs. Of these, 9.4% were classified as high level of propensity. Higher normative/impact need and greater propensity-related need directly predicted use of dental services at one-year follow up. The latter mediated the association of normative/impact need and propensity-related need with incidence of dental caries and filled teeth. Normative/impact need and use of dental services were directly associated with filled teeth at one-year follow up. Poor OHRQoL at one-year follow-up was directly predicted by higher normative/impact need at baseline and less filled teeth at one-year follow up. Greater socioeconomic status was directly associated with better propensity-related need. Socioeconomic status indirectly predicted incidence of dental caries and filled teeth via propensity-related need and use of dental services. CONCLUSIONS: Sociodental needs measures were related to use of dental services, dental caries, filled teeth and OHRQoL after one year among adolescents living in deprived communities. Adolescents with dental needs treatment priorities according to the sociodental approach had more filled teeth via use of dental services. Dental services utilisation did not attenuate the impact of normative and impact-related need on dental caries incidence and poor OHRQoL after one year. Our findings suggest the importance of developing oral health promotion and enhancing access to dental care to improve oral health of adolescents living in deprived communities.

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OBJECTIVES: This study examines the relationships between socio-economic status, psychosocial factors, health-related behaviours and the incidence of dental caries amongst 12-year-old schoolchildren living in deprived communities in Manaus, Brazil. METHODS: A longitudinal study involving 312 children aged 12 years was conducted in the city of Manaus, Brazil. Baseline data including socio-economic status (number of goods, household overcrowding, parents' schooling, family income), psychosocial factors (sense of coherence [SOC-13], social support [Social Support Appraisals questionnaire]) and health-related behaviours (frequency of toothbrushing, sugar consumption, sedentary behaviour) were collected through structured questionnaires. The number of decayed teeth was clinically assessed at baseline and one-year follow-up. A hypothesised model evaluating the direct and indirect pathways between the variables was tested using confirmatory factor analysis and structural equation modelling. RESULTS: The incidence of dental caries at the one-year follow-up was 25.6%. Sugar consumption (ß = 0.103) and sedentary behaviour (ß = 0.102) directly predicted the incidence of dental caries. A higher socio-economic status was directly linked with lower sugar consumption (ß = -0.243) and higher sedentary behaviour (ß = 0.227). Higher social support directly predicted lower sugar consumption (ß = -0.114). Lower socio-economic status (ß = -0.046) and lower social support (ß = -0.026) indirectly predicted the incidence of dental caries via sugar consumption and sedentary behaviour. CONCLUSIONS: In the population studied, sugar consumption and sedentary behaviour are meaningful predictors of the incidence of dental caries amongst schoolchildren living in deprived communities. Indirect pathways of lower socio-economic status and low social support with dental caries incidence via sugar consumption and sedentary behaviour were detected. These findings should be considered in oral interventions and oral health care policies to prevent dental caries amongst children living in deprivation. CLINICAL SIGNIFICANCE: Social conditions, social support, sedentary behaviour and sugar consumption directly influence dental caries in children.

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BACKGROUND: Dental fear affects children's oral health; there is, however, no evidence regarding the pathways linking possible predictors for its occurrence. AIM: This study aimed at exploring the direct and indirect effects of sociodemographic, clinical, behavioural and psychosocial factors on the development of dental fear in schoolchildren over time. DESIGN: This is a prospective cohort study, with 10 years of follow-up. The first assessment started in 2010 (T1) with a sample of 639 children aged 1-5 years from Southern Brazil. For this study, the follow-up (T2) of these individuals was performed in 2020. Dental fear was assessed at T2 using the Brazilian version of the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS). Socio-economic, demographic, psychosocial and oral health measures were collected in both assessments. A structural equation model was performed to assess the direct and indirect pathways among variables at T1 and T2 to predict the CFSS-DS scores at T2. RESULTS: Of the 639 children, 429 were re-evaluated at T2. Higher levels of untreated dental caries, younger individuals, dental visits for nonroutine reasons and low sense of coherence at T2 directly impacted dental fear at T2. Considering the indirect effects, the presence of dental caries and low household income at T1 indirectly impacted higher levels of dental fear over 10 years via dental caries at follow-up. CONCLUSION: Our findings suggest that socio-economic, demographic, clinical, psychosocial and behavioural conditions can influence dental fear from childhood to adolescence.

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There is a consensus around the importance of environmental education in mitigating the ill effects of environmental problems and preserving the natural environment and promoting green behaviours. The present paper studies the role of environmental education based on transformative learning theory. It intends to present and test a model proposal using sequential mediation analysis of several constructs as the Environmental Education Support (EES) and Volunteer Attitude (VA). A quantitative study was carried out by using data obtained through online questionnaires from several Indian and Brazilian Higher Education Institutions. A multivariate statistical method was employed to analyse the data by using partial least squares structural equation modelling. The results demonstrated that environmental education positively influences students' environmental concern, willingness to be environmentally friendly, and volunteer attitude. As a novelty, it reports that environmental education beliefs, concern for the environment and willingness to be environmentally friendly sequentially mediate the relationship between environmental education support and volunteering attitude.

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OBJECTIVES: Oral health behaviour is a learning process that begins in the early years of an individual's life. The aim of this study was to evaluate the associations between demographic, socioeconomic, and psychosocial factors and oral health behaviours during the transition period from childhood to adolescence. METHODS: This was a cohort study with a follow-up of 7 years. The baseline assessment occurred in 2010 with a random sample of 639 preschool children from southern Brazil. Demographic, socioeconomic and psychosocial oral health conditions were assessed at baseline. Oral health habit variables were collected at follow-up and included questions regarding dental care and oral hygiene behaviours. Structural equation modelling was performed to assess the direct and indirect relationships between predictors at baseline in oral health behaviours at follow-up. RESULTS: A total of 449 children were re-examined at follow-up (70.3% cohort retention rate). Factors directly related to poorer oral health behaviours (lower use of dental services, dental visits for emergency reasons and lower frequency of toothbrushing) were lower household income, lower maternal education, lower frequency of visits to neighbours or friends, and male sex. Considering indirect pathways, the household income and maternal education at baseline influenced oral health behaviours at follow-up via visits to neighbours or friends. CONCLUSIONS: Our findings suggest that household income, maternal education and social capital play an important role in the development of oral health behaviours during the transition from childhood to adolescence. Acquisition of healthy oral behaviours is an important factor to consider in childhood. With this knowledge, public health policies can be developed to intervene in specific causal factors and improve oral health during this transitional period.

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The present study has three main objectives: a) to analyse, for the first time, the factor structure of the Control of Eating Questionnaire (CoEQ) in a Brazilian sample; b) to explore, through in-depth interviews, motivators and consequences of food cravings among participants with high scores on the CoEQ; and c) to analyse whether and how the power of food is related to food cravings. The study involved 335 young adults aged 18-30 years, balanced for sex. The CoEQ and the Power of Food Scale (PFS) were used in an online survey. The CoEQ and PFS were subjected to confirmatory factor analysis. Semi-structured interviews were also conducted with a subsample (n = 20) with high CoEQ scores. The Socratic questioning method was used for the interviews. The interviews were transcribed and analysed according to thematic content analysis. The PFS and the CoEQ showed adequate factor structure with reliable factors. The results of the qualitative analysis showed that both food availability and seeking relief from stressors serve as motives for food cravings. Concern for health and weight gain were cited as consequences of cravings, as was seeking distraction to cope with these cravings. It was found that the PFS aggregate factor was a significant influencing factor for craving control (ß = 0.604; p < 0.001), craving for savoury (ß = 0.382; p < 0.001), craving for sweet (ß = 0.414; p < 0.001) and positive mood (ß = -0.198; p < 0.001). The findings suggest that the relationship between food cravings and the power of food is significant in today's obesogenic environment.

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OBJECTIVES: To explore the pathways by which oral health literacy is associated with dental caries in adolescents, assessing direct and indirect effects of family cohesion and socioeconomic status. METHODS: A population-based, representative cross-sectional study was conducted with 740 12-year-old adolescents in Campina Grande, Brazil. Parents/guardians answered a sociodemographic questionnaire. Adolescents answered validated questionnaires addressing family cohesion and oral health literacy. Dental caries was diagnosed using Nyvad criteria. Two dentists underwent training exercises for the diagnosis and administration of the questionnaires (k > 0.80). Descriptive analysis was followed by the use of structural equation modelling to determine direct and indirect associations between the variables incorporated into the theoretical model of the study (95% CI). RESULTS: Oral health literacy (standardized coefficient: -3.472, p < .01) and mother's schooling (standardized coefficient: -0.405, p < .01) were directly associated with dental caries, whereas family cohesion and socioeconomic status exerted an indirect effect on the occurrence of dental caries in the adolescents. CONCLUSIONS: Sociodemographic factors, family characteristics and oral health literary are associated with dental caries in 12-year-old adolescents.

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Cárie na primeira infância (CPI) e má oclusão podem afetar a qualidade de vida relacionada à saúde bucal (QVRSB) de crianças e suas famílias. Fatores psicossociais relacionados às crianças, suas famílias e comunidade na qual estão inseridas devem ser estudados. Diante disso, os objetivos desta tese foram: 1) verificar a associação entre fatores psicossociais associados à CPI e à QVRSB em pré-escolares e suas famílias (Artigo 1); 2) avaliar o impacto da mordida aberta anterior (MAA) e da mordida profunda (MP) na QVRSB de préescolares, e verificar o papel da resiliência parental como um fator moderador nessa associação (Artigo 2). Foi realizado um estudo transversal representativo com pré-escolares de 4-6 anos de idade e seus pais/responsáveis em Ribeirão das Neves, MG, Brasil. Os pais/responsáveis responderam às versões brasileiras do Early Childhood Oral Health Impact Scale (ECOHIS) e Escala de Resiliência, e um questionário com dados socioeconômicos e de comportamento de saúde bucal da criança. Os pré-escolares foram examinados por duas dentistas treinadas e calibradas para o diagnóstico de CPI e consequências pulpares de lesões cariosas não tratadas (Kappa>0,95), utilizando-se a versão epidemiológica do International Caries Detection and Assessment System (ICDASepi) combinado com o índice pufa e, assim categorizados: sem cárie, estágio inicial (opacidade notável/pigmentação retida em fundo de fóssulas e fissuras), estágio moderado (cavitação em esmalte/sombreamento em dentina subjacente), estágio extenso sem consequências pulpares (cavitação com exposição dentinária) e estágio extenso com consequências pulpares (cavitação com exposição dentinária, com envolvimento pulpar e/ou presença de fístulas/abscessos). A presença de MAA e MP foi avaliada através do índice de Foster e Hamilton. Os dados foram analisados por meio da modelagem por equações estruturais, utilizando-se o software Mplus, versão 8.6 (Artigo 1) e por meio da análise de moderação, utilizando-se o PROCESS (PROCESS for SPSS, version 3.4) (Artigo 2). Os resultados do artigo 1 demonstraram que menor status socioeconômico (ß =-0,250; p<0,001) e maior frequência de consumo de açúcares livres (ß=0,122; p=0,033) foram associados diretamente com estágio extenso de cárie com consequência pulpar, enquanto menor resiliência dos pais impactou indiretamente estágios mais avançados da CPI, por meio da variável frequência de consumo de açúcares livres (ß =-0,089; p=0,048). Além disso, CPI foi associada com piores escores tanto da QVRSB da criança (b=0,587; p<0,001) quanto da família (ß =0,506; p<0,001). Os resultados do artigo 2 demonstraram que préescolares filhos de pais com baixa resiliência, e que possuíam MAA apresentaram impacto negativo na QVRSB (ß:3,95;p=0,025) em comparação àqueles que apresentaram oclusão normal. A resiliência parental não atuou como fator moderador na associação entre MP e QVRSB (p>0,05). Conclui-se que quanto maior a gravidade da CPI, maior o impacto negativo na QVRSB de pré-escolares e suas famílias. Os principais fatores associados à CPI mais grave foram menor nível socioeconômico, maior frequência de consumo de açúcar livre e menor resiliência parental (Artigo 1). MAA interferiu negativamente na QVRSB dos pré-escolares, sendo essa associação mais forte quando a resiliência parental era baixa. Portanto, a resiliência dos pais atuou como fator moderador na relação entre MAA e QVRSB (Artigo 2).

Early childhood caries (ECC) and malocclusion can affect the oral health-related quality of life (OHRQoL) of children and families. Psychosocial factors related to children, their families and the community in which they are inserted must be studied. Therefore, the objectives of this thesis were: 1) to verify the association between psychosocial factors with ECC and OHRQoL in preschoolers and their families (Manuscript #1); 2) to evaluate the impact of anterior open bite (AOB) and deep bite (DB) on the OHRQoL of preschool children and the role of parental resilience as a moderating factor in such association (Manuscript #2). A representative crosssectional study was carried out with 4-to-6-year-old preschoolers and their parents/caregivers from Ribeirão das Neves, MG, Brazil. Parents/caregivers selfadministered the Brazilian versions of the Early Childhood Oral Health Impact Scale (ECOHIS) and the Resilience Scale, as well as a questionnaire about socioeconomic and child's oral health behavior data. Preschoolers were examined by two trained and calibrated dentists for the diagnosis of ECC and pulpal consequences of untreated carious lesions (Kappa>0.95), using the epidemiological version of the International Caries Detection and Assessment System (ICDASepi) index combined with the pufa index: no caries, early stage (notable opacity/retained pigmentation in the background of pits and fissures), moderate stage (cavitation in enamel/shading in underlying dentin), extensive stage without pulpal consequences (cavitation with dentin exposure) and extensive stage with pulpal consequences (cavitation with dentin exposure, and pulp involvement and/or fistulas/abscesses). The presence of AOB and DB were evaluated using the Foster and Hamilton index. Data were analysed through Structural Equation Model (SEM), using the Mplus software, version 8.6 (Manuscript #1) and through moderation analysis, using PROCESS (PROCESS for SPSS, version 3.4) (Manuscript #2). The results of the Manuscript #1 demonstrated that lower socioeconomic status (b=-0.250; p<0.001) and higher frequency of consumption of free sugars (ß=0.122; p=0.033) were directly associated with an extensive stage of caries with pulpal consequences, while lower parental resilience indirectly impacted more advanced stages of ECC, through the variable frequency of consumption of free sugars (b=-0.089; p=0.048). In addition, ECC was associated with worse scores in both the child's (ß=0.587; p<0.001) and the family's (ß=0.506; p<0.001) OHRQoL. The results of the Manuscript #2 demonstrated that preschoolers whose parents presented low resilience, and preschoolers who presented OAB, had a negative impact on OHRQoL (ß:3.95; p=0.025) compared to those who had normal occlusion. Parental resilience did not act as a moderating factor in the association between DB and OHRQoL (p>0.005). It is concluded that the severity of ECC negatively impacted the OHRQoL of preschoolers and their families, and the main factors associated with the severity of ECC were lower socioeconomic status, higher frequency of free sugar consumption and lower parental resilience (Manuscript #1). OAB negatively interfered with the OHRQoL of preschoolers, with this association being stronger when parental resilience was low. Therefore, parental resilience acted as a moderating factor in the relationship between OAB and OHRQoL (Manuscript # 2).

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