Thesis (Ph. D.)--University of Washington, 2000. / Vita. Includes bibliographical references (leaves 145-160).

Only a small number of studies dealing with burnout among coaches have been published, and none of these have dealt with burnout among elite soccer coaches in a European context. This thesis – investigating both the burnout and recovery process – includes a longitudinal design spanning ten years. Out of 53 head coaches, from elite soccer teams in Sweden, 47 participated in study 1. Results showed that burnout scores assessed by Maslachs Burnout Inventory (MBI) were generally low, but coaches in women’s premier league showed significantly higher levels of emotional exhaustion than coaches in men’s soccer teams. A sub-sample of these 47 coaches was interviewed for study 2, namely those 8 reporting the highest MBI scores. Characteristics of the elite coach professions personality traits and the allover life situation of the coach were identified as risk factors for developing burnout, as well as some retention factors, risking to create detention effects which might worsen the stress levels of the coach. In study 3 and 4, the burnout and recovery processes were examined, respectively. On the basis of descriptions from the coaches, three separate phases are discerned from the burnout process: a phase of restlessness and annoyance, a fatigue phase and finally a phase of exhaustion and burnout, while it is possible to make out four phases in the recovery process: a wake-up process, a phase removing one-self, a phase of reflection and evaluation, and finally a phase of new-orienting one-self. Study 5 revealed that both energy cost reducing strategies and energy boosting activities, were used by the coaches to prevent burnout. Study 6 showed that lack of sufficient recovery periods inhibited a lowering of the burnout levels, but also that lack of adequate coping strategies slowed the recovery process and also that coaches who have experienced burnout have an impaired professional efficiency. Finally, the focus in study 7 was on longterm consequences of burning out. Increased fatigue, diseases, cognitive impairment and a lower stress tolerance were examples of negative consequences, whereas an improved ability to identify stress causes and an enhanced awareness about one’s stress reactions, as well as to reflect and prioritize health, were examples of positive and favourable consequences. It is also urgent that elite clubs strive to create a good psycho-social work environment, which will function as a buffer against stress.

The objectives of the study were to determine the incidence of falls, the prevalence of fear of falling and fall risk factors and consequences in adults with rheumatoid arthritis (RA). 559 community dwelling adults with RA, aged 18 to 88 years (mean age 62; 69% female) participated in this prospective cohort study. Patients were recruited from four outpatient clinics in the Northwest of England and followed for 1 year after clinical assessment, using monthly falls calendars and telephone calls. Outcome measures included fall occurrence, reason for fall, type and severity of injuries, fractures, fall location, lie-times, use of health services and functional ability. Risk factors for falls included lower limb muscle strength, postural stability, number of swollen and tender joints, functional status, history of falling, fear of falling, pain, fatigue and medication. Data on demographics, vision, co-morbidities, history of surgery, fractures, and joint replacements were also recorded.535 participants followed for one year had a total of 598 falls. 36.4% participants (95% CI 32% to 41%) reported falling with an incidence rate of 1313/1000 person-years at risk or 1.11 falls per person. Over one third of the falls were reportedly caused by hips, knees or ankle joints giving way. Over half of all the falls resulted in moderate injuries, including head injuries (n=27) and fractures (n=26). Univariate logistic regression showed that falls risk was independent of age and gender. A history of falls in the previous one year was a strong medical fall predictor with an odds ratio (OR) for a single fall=3.3 and for multiple falls OR=4.3. Fear of falling was an important self-reported psychological predictor, with the risk increasing by 10% with each point above 7 (up to 28) in the Short FES-I score. The inability to complete the Four Test Balance Scale due to poor balance was a strong postural fall predictor (OR 2.3). The most significant functional predictor of falls was the functional Health Assessment Questionnaire score, and each additional point attained in the score (1-4) nearly doubled the risk of further falls. Multivariate logistic regression revealed that when taken in combination with other factors, a history of multiple falls in the previous one year was the most significant predictive risk factor (OR=5.3) and overall the model accounted for 71% of variation. The most significant modifiable risk factors were swollen and tender lower limb joints (hip, knee and ankle) (OR=1.7), psychotropic medication (OR=1.8) and increasing fatigue (OR=1.13) with this model accounting for 68% of variation. Adults of all ages with RA are at high risk of falls and fall-related injuries, fractures and head injuries. In clinical practice, high risk falls patients with RA can be identified by asking whether patients have fallen in the past year. The management of swollen and tender lower limb joints, fatigue and consideration of psychotropic medicines may be the most effective strategy to reduce falls in this group of patients. Fear of falling, pain, lower limb strength and poor balance are other useful clinical indicators that may be modified to prevent falls.

Objetivo: Avaliar a incidência de tromboembolismo e as condições clínicolaboratoriais associadas em pacientes pediátricos internados em um hospital terciário. Pacientes e métodos: Estudo retrospectivo onde foram revisados os prontuários de todas as 6140 crianças de 0 à 13 anos que internaram entre fevereiro de 2007 à janeiro de 2009. Foram identificadas 31 crianças que tiveram 34 casos de tromboembolismo confirmado por diagnóstico de imagem, e estas foram incluídas no banco de dados para análise. Resultados: A incidência de tromboembolismo foi de 43,3 (intervalo de confiança de 95%: 30,0-60,4) para cada 10.000 internações. Vinte e seis (83,9%) crianças tinham condições clínicas associadas, sendo que 11 (35,4%) tinham apenas 1 condição associada, 5 (16,1%) tinham 2 condições associadas, 6 (19,3%) tinham 3 condições associadas, 4 (12,9%) tinham 4 condições associadas e 5 (16,1%) não tinham condições associadas. As frequências das principais condições clínico-laboratoriais foram: sepse, 41,9%; trombofilias, 35,5%; cardiopatia acianótica, 29,9%; e cateter central, 22,5%. Conclusão: O presente estudo evidenciou uma incidência de tromboembolismo muito mais alta do que a descrita na literatura, provavelmente devido ao estudo ter sido realizado em um hospital terciário, com maior complexidade e complicações associadas mostrando a importância de considerar este diagnóstico. Observamos também uma alta taxa de trombofilias nos pacientes que tiveram tromboembolismo, salientando que a associação de fatores de risco e predisposição genética ou fatores intrínsecos devem ser considerada no diagnostico e manejo destes pacientes. / Objective: To assess the incidence of thromboembolism and associated clinical conditions and laboratory abnormalities in a sample of pediatric patients admitted to a tertiary referral center. Methods: This was a retrospective chart review study. The medical records of all 6140 children between the ages of 0 and 13 years admitted to the study facility from February 2007 through January 2009 were reviewed. A total of 34 cases of imaging-confirmed thromboembolism were identified in 31 children and included for analysis. Results: The incidence of thromboembolism was 43.3 (95%CI, 30.0–60.4) per 10,000 admissions. Twenty-six children (83.9%) had associated clinical conditions: 11 (35.4%) had only 1 associated condition, 5 (16.1%) had 2 associated conditions, 6 (19.3%) had 3 associated conditions, 4 (12.9%) had 4 associated conditions, and 5 (16.1%) had no associated conditions. The main associated conditions were sepsis (41.9%), thrombophilia (35.5%), acyanotic heart disease (29.9%), and central venous catheterization (22.5%). Conclusion: In the sample studied herein, the incidence of thromboembolism was much higher than that reported in the literature, most likely due to the study setting (tertiary referral hospital) and its implications (greater case complexity and frequency of complications), stressing the importance of considering the diagnosis. Furthermore, among patients who developed thromboembolism, there was a high rate of thrombophilia, highlighting the importance of the association between risk factors and genetic predispositions or intrinsic factors in the diagnosis and management of these patients.

Objective: To determine the risk factors for extubation failure in the intensive care unit. Methods: The present case-control study was conducted in an intensive care unit. Failed extubations were used as cases, while successful extubations were used as controls. Extubation failure was defined as reintubation being required within the first 48 hours of extubation. Results: Out of a total of 956 patients who were admitted to the intensive care unit, 826 were subjected to mechanical ventilation (86%). There were 30 failed extubations and 120 successful extubations. The proportion of failed extubations was 5.32%. The risk factors found for failed extubations were a prolonged length of mechanical ventilation of greater than 7 days (OR = 3.84, 95%CI = 1.01 - 14.56, p = 0.04), time in the intensive care unit (OR = 1.04, 95%CI = 1.00 - 1.09, p = 0.03) and the use of sedatives for longer than 5 days (OR = 4.81, 95%CI = 1.28 - 18.02; p = 0.02). Conclusion: Pediatric patients on mechanical ventilation were at greater risk of failed extubation if they spent more time in the intensive care unit and if they were subjected to prolonged mechanical ventilation (longer than 7 days) or greater amounts of sedative use. / Revisión por pares / Revisión por pares

Inflammatory breast cancer (IBC) is a rare and aggressive form of breast cancer, with a particularly poor prognosis. Identification of epidemiologic risk factors for IBC might shed light on causes of the disease, and guide screening and perhaps treatment. Previous studies have suggested that race, geographic location, body mass index (BMI), menopausal status, age at menarche, parity, duration of lactation, and exposure to mouse mammary tumor virus may be key risk factors in the development of IBC. This retrospective epidemiologic study examines the risk factors for IBC in predominantly Caucasian patients treated at the Dana Farber Cancer Institute (DFCI) in Boston, MA. The risk factors that were examined in this study include the following: BMI, family history of having breast cancer, comorbidities, duration of symptoms associated with IBC prior to diagnosis, season of diagnosis, and molecular subtypes of breast cancer. Additionally, the descriptive statistics for the mean age of diagnosis, race, menopausal status, genetic predisposition, and the presence of metastases in distant organs were also determined. This study showed that there is some evidence of a hereditary component and seasonal variation to the disease. Furthermore, this study reiterates the association of high body mass index (BMI) and IBC. The data collected from the DFCI IBC patient population suggest that modifiable lifestyle factors, perhaps due to a lack of awareness of the disease, might be crucial in the development of IBC. Further research is needed to explore the unique risk factors in developing IBC elucidated in this study in order to better understand and prevent such an aggressive disease.

O objetivo desta pesquisa foi descrever o desenvolvimento motor de crianças de 0 a 18 meses de idade, identificando os principais fatores de risco para atraso motor, assim como, analisar a validade da Alberta Infant Motor Scale para avaliação do desenvolvimento motor de crianças gaúchas, verificando a representatividade de seus critérios motores. A amostra deste pesquisa foi de 561 crianças, provenientes de Escolas de Educação Infantil, Creches, Entidades e Unidades Básicas de Saúde. Os instrumentos utilizados na coleta de dados foram: 1) Alberta Infant Motor Scale (AIMS); 2) Affordance in the Home Environment Motor Development (AHEMD); 3) Questionário estruturado com perguntas sobre características biológicas. Das crianças avaliadas, 63,5% foram consideradas com desenvolvimento motor normal para idade, sendo que os bebês com idade entre 3 e 12 meses foram os que demonstraram pior desempenho. Foi observado uma inferioridade nos comportamentos motores referentes as posturas prono e em pé. Entre os fatores biológicos de maior influência, destacaram-se o baixo peso ao nascer, a prematuridade e o tempo de internação na UTI. No que se refere aos fatores sócio-ambientais, destacaram-se a escolaridade dos familiares; o grau de instrução paterna, a renda familiar mensal, o número de adultos e de crianças que vivem na casa, tempo carregado no colo e número de brinquedos para motricidade fina e ampla. Quanto ao processo de Validação da AIMS, as análises de correlação, associação e consistência interna indicaram que a AIMS é válida e fidedigna para população gaúcha. Conclui-se que as crianças apresentaram seqüência progressiva do aparecimento de habilidades motoras nas posturas avaliadas, porém parte destas foram consideradas com desenvolvimento motor inferior ao esperado para idade. Sugere-se que os fatores biológicos, contextuais e o instrumento de avaliação influenciaram no desenvolvimento motor das crianças avaliadas, sendo a AIMS um instrumento significativamente útil e confiável para utilização em várias áreas da pesquisa científica e clínica. / The purpose of the present study was describe the motor development of infants aging from 0 to 18 months and verify the influence of the biological and socio-environmental risk factors and analyze the validation of Alberta Infant Motor Scale to evaluate the motor development of southern children, analyzing the representativeness of the instrument´s items. The sample was composed of 561 children, coming from Kinder gardens, Children Education schools, Health Basic Units of Rio Grande do Sul. The instruments used were: 1) Alberta Infant Motor Scale (AIMS); 2) Affordance in the Home Environment Motor Development (AHEMD); 3) biological factors through structured questionnaire. From the evaluated infants, 63, 5% were considered with a regular motor development for their age, and the babies aging from 3 to 12 months were the ones with the worst development. It was found inferiority in the motor behaviors regarding the prono and standing postures. Among the biological factors with a major influence, the low weight when they are born, the prematureness and the time they spend in the intensive treatment unit (ITU) are prominent. In relation to the socioenvironmental factors, the parents’ schoolarity; the father’s instruction, the family’s income, the number of adults and children that live in the house, the time being hold and the number of toys for fine and global motricity. On the Validation process, the analysis of correlation, association and internal consistency indicate that the AIMS is valid and trustworthy in the evaluation of infants motor acquisitions of southern children. Conclused that the infants from this study presented a progressive sequence of appearance of motor abilities in the evaluated postures, however parts of these were considered with an inferior motor development according to what was expected by their age. It is suggested that, either the socio-environment risk factor as well as the biological and evaluation instrument influenced in the motor development of the infants, being the AIMS a significatively useful and reliable instrument to several areas of clinic and scientific research.

Objetivos: Esta tese teve como objetivo avaliar a relação entre saúde bucal e função cognitiva através de uma revisão sistemática com metanálise e de um estudo transversal. Métodos: Para a revisão sistemática e metanálise, foram selecionados estudos de coorte prospectivos publicados entre 1990 e 04 de dezembro de 2014, através do banco de dados PubMed, Embase, PsycoINFO e Cochrane Library of Systematic Reviews. A razão de riscos agrupados (HR), com intervalo de confiança de 95% (IC 95%), foi calculada, para estimar o efeito, usando-se o modelo de efeitos aleatórios. Além disso, foi realizado um estudo transversal, aninhado na coorte da cidade de Carlos Barbosa, situada no Sul do Brasil. Os dados incluídos são de 117 idosos edentados (média de idade 73.7± 5.6 anos) usuários de prótese total, avaliados em 2013. A função cognitiva foi avaliada usando a versão brasileira do Mini-Exame do Estado Mental (MEEM). A qualidade funcional das próteses foi avaliada através de exame clínico, e a dificuldade mastigatória foi auto-reportada. A análise dos dados foi realizada por meio de modelos de regressão linear. Resultados: A revisão sistemática selecionou dez estudos de coorte; dentre estes, oito foram incluídos na metanálise. Em comparação aos indivíduos com uma dentição considerada ideal (≥ 20 dentes), os indivíduos com uma dentição considerada não adequada tiveram um risco significativamente maior de ter declínio cognitivo (HR = 1.28 IC 95%: 1.15-1.41) e demência (HR = 1.22 IC 95%: 1.04-1.43). No estudo transversal, o escore médio do MEEM da amostra total foi de 23.1 (DP= 4.4) e foi associado com a idade (p= .001), educação (p< .0001), sintomas depressivos (p= .003), dificuldade mastigatória (p= .001) e com a qualidade funcional das próteses (p< .0001). No modelo final, a dificuldade mastigatória foi associada com a função cognitiva após o ajuste para fatores de risco significativos (p= .002). Conclusão: Os resultados da revisão sistemática e metanálise de estudos de coorte prospectivos e do estudo transversal suportam a hipótese de associação entre saúde bucal/mastigação e estado cognitivo. Relevância clínica: O potencial efeito benéfico de uma dentição adequada e próteses funcionais no estado cognitivo, através da mastigação, poderia adicionar estratégias preventivas para diminuir o risco de morbidade em idosos. / Objectives: To evaluate the relationship between oral health and cognitive function through a systematic review/meta-analysis as well as a cross-sectional study. Methods: For the systematic review and meta-analysis, relevant articles published between 1990 and 4 December 2014 were identified by searching the PubMed, EMBASE, PsycoINFO, and Cochrane library databases. Pooled hazard ratios (HRs) with 95% confidence interval (CI) were calculated with a random-effects model. For the second objective we performed a cross-sectional study nested in a cohort study conducted in 2013. We evaluated 117 elderly edentulous individuals (mean age 73.7 ± 5.6 years) wearing complete denture, and residing in Carlos Barbosa, Rio Grande do Sul, Brazil. Cognitive function was assessed using the Brazilian version of the Mini-Mental State Examination. Clinical examination was conducted to evaluate the quality of denture, and masticatory difficulty was self-reported. Data were analyzed using linear regression models. Results: The systematic review selected 10 cohort studies, of which 8 were included in the metaanalysis. Compared with the patients who had optimal dentition (≥20 teeth), individuals with suboptimal dentition had a significantly increased risk of having cognitive decline (HR=1.28, 95% CI: 1.15–1.41) and dementia (HR=1.22, 95% CI: 1.04–1.43). In the cross-sectional study, the mean MMSE score for the total sample was 23.1 (SD=4.4) and was associated with age (p=.001), education (p<.0001), depressive symptoms (p=.003), as well as perceived masticatory disability (p=.001) and the functional quality of dentures (p<.0001). Perceived masticatory disability was associated with cognitive status (p=.002) after adjusting for significant risk factors. Conclusion: The results of the systematic review and meta-analysis of prospective cohort studies as well as the cross-sectional study lend support to the hypothesized association between oral health/mastication and cognitive status. Clinical Significance: The potential beneficial effect of an optimal dentition and functional dentures on cognitive status, via mastication, could suggest preventive strategies to decrease substantial risk of morbidity in elders.

Submitted by Ana Maria Fiscina Sampaio (fiscina@bahia.fiocruz.br) on 2012-08-02T21:29:09Z No. of bitstreams: 1 Pricila Brito Magalhães. Ocorrencia de Leishmaniose visceral humana num ecossistema de manguezal.pdf: 2019963 bytes, checksum: 4cd382e434745709deb814ea88bad0c0 (MD5) / Made available in DSpace on 2012-08-02T21:29:10Z (GMT). No. of bitstreams: 1 Pricila Brito Magalhães. Ocorrencia de Leishmaniose visceral humana num ecossistema de manguezal.pdf: 2019963 bytes, checksum: 4cd382e434745709deb814ea88bad0c0 (MD5) Previous issue date: 2009 / Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, Bahia, Brasil / A leishmaniose visceral humana (LVH) é reconhecida como uma importante doença infecciosa emergente em muitas áreas do mundo. Recentemente, a ocorrência de LVH na periferia de grandes centros urbanos tem causado preocupação à saúde pública. É uma doença insidiosa, com espectro amplo, variando desde a infecção assintomática a casos com doença grave. Já foi descrita em diversos tipos de ambientes e climas, dentre eles não há referências sobre o encontro de casos em manguezal. Assim, o objetivo deste trabalho é Investigar um surto de Leishmaniose Visceral Humana em ecossistema de manguezal, descrevendo as características dos casos confirmados da doença, avaliando a prevalência de infecção por Leishmania em outros moradores dos domicílios com caso, identificando a presença do Lutzomyia longipalpis no domicílio e peridomicílio e, avaliando a prevalência de casos de leishmaniose canina na região. O surto ocorreu no município de Salinas da Margarida, cidade situada no nordeste do Brasil, em 2004. Todos os outros moradores do domicílio (controles) foram avaliados quanto à evidência de infecção prévia por Leishmania sp. usando o teste de Intradermo Reação de Montenegro (IDRM). A presença de pápula/ nódulo, ≥5 mm ou ulceração foi considerada como IDRM positiva. Os fatores de risco foram investigados através de questionário testado e validado. No total, 26 casos foram relatados em 2004. Cerca de 54% eram homens e 46% eram mulheres; 50% tinham menos de 10 anos e a maioria dos casos (69,2%) ocorreram no Distrito de Encarnação, seguido de Pirajuía (11,5%). Todos os pacientes foram diagnosticados pela demonstração parasitológica de Leishmania sp. ou pela apresentação clínica (febre, hepatoesplenomegalia e pancitopenia) com ou sem resposta à terapia antimonial. Foram capturados flebótomos (Lutzomyia longipalpis) em metade das casas (13/26) onde os casos moravam. Foram avaliados 145 moradores (26 casos e 119 controles). Em cerca de 35% dos domicílios 100% dos moradores não-caso apresentavam evidência de infecção. E em 81% das residências (21 de 26) metade ou mais dos moradores nãocaso tinham evidência de infecção. Cerca de 60% dos domicílios tinham cão e em metade das residências foi encontrado flebótomo (Lutzomyia longipalpis) numa única tentativa de captura. Dentre os fatores de risco investigados para LVH, o consumo/ abuso de bebida alcoólica foi significativamente associado à maior chance de desenvolver doença aparente (OR= 10,6). Nosso estudo indica, pela primeira vez, a ocorrência da LVH em um ecossistema de manguezal, inusitado para a adaptação do flebótomo. Os dados indicam também que a maioria dos moradores de domicílios onde ocorreu caso de LVH tem evidência de infecção por Leishmania sp., embora a maioria não desenvolva doença aparente. As implicações destes achados devem ser mais estudadas. / The Human Visceral Leishmaniasis (LVH) is recognized as an important emerging infectious disease in many areas of the world. Recently, the occurrence of LVH in the outskirts of large urban centers have caused concern to public health. It is an insidious disease, with broad spectrum, ranging from asymptomatic infection to cases of serious illness. It has been described in many types of environments and climates, among them there are no references about the meeting where mangroves. The objective of this study is to investigate an outbreak of Kala-azar in mangrove ecosystem, describing the characteristics of confirmed cases of the disease, assessing the prevalence of Leishmania infection in other residents of the homes with the case, identifying the presence of Lutzomyia longipalpis in domiciliary areas and assessing the prevalence of cases of canine leishmaniasis in the region. The outbreak occurred in the city of Salinas da Margarida, a city in northeastern Brazil, in 2004. All other household members (controls) were evaluated for evidence of prior infection with Leishmania sp. using the test “IntradermoReação de Montenegro (IDRM)”. The presence of papule / nodule ≥ 5 mm or ulceration was seen as positive IDRM. The risk factors were investigated through a questionnaire and tested. In total, 26 cases were reported in 2004. About 54% were men and 46% were women, 50% had less than 10 years and most cases (69.2%) occurred in the district of Incarnation, followed by Pirajuía (11.5%). All patients were diagnosed by parasitological demonstration of Leishmania sp. or by clinical presentation (fever, hepatosplenomegaly and pancytopenia) with or without response to antimonial therapy. Were captured sandflies (Lutzomyia longipalpis) in half of the homes (13/26) where the cases lived. We assessed 145 residents (26 cases and 119 controls). In about 35% of households 100% non-residents' case had evidence of infection. And in 81% of households (21 of 26) half or more of non-residents if they had evidence of infection. About 60% of households had dogs and half of the homes was found sandfly (Lutzomyia longipalpis) in a single attempt to capture. Among the investigated risk factors for LVH, the use / abuse of alcohol was significantly associated with greater chance to develop apparent disease (OR = 10.6). Our study indicates for the first time, the occurrence of LVH in a mangrove ecosystem, unusual for the adaptation of the sandfly. The data also indicate that most residents of households where there was case of LVH has evidence of infection by Leishmania sp., Although most do not develop apparent disease. The implications of these findings should be further investigated.

Antecedentes e justificativa: O Desgaste erosivo (DE) é a perda acelerada de tecido dentário duro pelo efeito combinado da erosão ácida e do desgaste mecânico (abrasão e atrição). Sua etiologia é multifatorial e complexa. DE é uma patología irreversível, acumulativa, que progride com a idade e por esses motivos se justifica a investigação dos possíveis fatores associados a este agravo em populações jovens. Este é o primeiro estudo que avalia a prevalência do DE em dentes permanentes dos escolares uruguaios. Objetivo: O objetivo dessa dissertação foi estudar a prevalência, extensão, severidade e distribuição intraoral do DE, e sua associação com variáveis socioeconômicas, ambientais e comportamentais, em escolares de 12 anos de Montevidéu, Uruguai. Metodologia: Foi desenvolvido um estudo observacional transversal analítico de base populacional em uma amostra representativa dos escolares de 12 anos de Montevidéu, Uruguai. A coleta de dados foi realizada entre agosto/2011 e julho/2012. Foram selecionadas aleatoriamente 44 escolas, 32 públicas e 12 particulares. Todas as crianças de 12 anos, regularmente matriculadas e frequentando regularmente essas escolas foram convidadas a participar. Dois questionários foram utilizados previamente ao exame clínico: um destinado aos pais/responsáveis (características socioeconômicas, escolaridade dos pais, condição de moradia, saúde, antecedentes médicos e odontológicos) e outro aos escolares (hábitos comportamentais e alimentares). Os exames clínicos foram realizados por duas examinadoras calibradas (Kappa≥0.7) a fim de registrar a presença e severidade do DE de acordo com o Basic Erosive Wear Examination (B.E.W.E) score system. Taxas de prevalência e extensão e seus intervalos de confiança (IC 95%) foram estimados. A associação entre DE severo e seus possíveis indicadores de risco foi avaliada através de modelos de regressão logística. Resultados: Foram examinados 1136 escolares neste estudo (19,1% de escolas particulares e 80,9% de escolas públicas) resultando em uma taxa de resposta de 66,6%. A prevalência observada de DE foi de 52,9% (n=601), sendo a grande maioria dos casos erosão leve (n=554). DE severo foi encontrado em 4,4% dos escolares (n=47). Na prevalência total foram observadas diferenças significativas entre as categorias de gênero e nível sócio-econômico enquanto que 11 somente entre as categorias de gênero na prevalência de DE severo. Na análise da extensão total foram encontradas diferenças significativas nas variáveis gênero, nível socioeconômico e hábito de realizar bochecho antes de engolir. Com relação à extensão de DE severo, as variáveis significativas foram realizar bochecho antes de engolir e frequência de escovação. Na análise ajustada, sexo masculino (OR=3.21, IC95%=1.50-6.89) e o consumo de iogurt ≥3 vezes ao dia (OR=3.98, IC95%=1.81-13.47) foram associados à presença de DE severo. Os dentes mais afetados foram os incisivos superiores em suas faces palatinas, seguido pelos primeiros molares (fases oclusais). Conclusões: A alta prevalência observada sugere que o DE pode ser considerado um problema de saúde pública em escolares uruguaios de 12 anos. O maior risco entre os meninos deve ser levado em consideração no desenvolvimento de estratégias de prevenção do DE. / Background: Erosive tooth wear (ETW) has been defined as the accelerated loss of mineralized dental tissue due to the combined effects of acid erosion and mechanical wear (abrasion or attrition). Its aetiology is multifactorial and complex. The progressive, cumulative and irreversible characteristics of ETW as well as its tendency to progress with aging, justify the investigation of possible risk indicators for its occurrence in young populations. This is the first study assessing the occurrence of ETW on permanent teeth of Uruguayan schoolchildren. Aims: to assess the prevalence, extent, severity and intraoral distribution of ETW and its association with socioeconomic, environmental and behavioral characteristics among 12-year-old schoolchildren in Montevideo, Uruguay. Methods: A population-based cross-sectional survey was conducted using a representative sample of 12-year-old schoolchildren, attending 32 public and 12 private schools, from August/2011 to July/ 2012. Firstly, 44 schools were randomly selected being 32 publics and 12 privates. All of 12-year-old schoolchildren attending such schools were invited to participate. Data was collected through two structured questionnaires prior to clinical oral examination: one sent to parents/legal guardians (socioeconomic status, parents’ educational level, housing conditions, general health, medical and dental history) and another were answered by the schoolchildren (behavioural and dietaty habits). Clinical examination was performed by two calibrated examiners (kappa≥0.7) in order to record the presence and severity of ETW according to the Basic Erosive Wear Examination (B.E.W.E.) score system. Prevalence and extent rates and their respective 95% confidence intervals (95% CI) were estimated. The association between severe ETW and its possible associated factors were analyzed using Logistic regression models. Results: In this study, 1136 schoolchildren were examined, 19.1% from private schools and 80.9% from public schools, yielding a response rate of 66.6%. The overall prevalence of ETW was 52.9% (n=601), being mild erosion in the vast majority of cases (48.5%) (n=554). Severe ETW was detected in 4.4% of schoolchildren (n=47). The overall prevalence of ETW differed significantly between categories of gender, socioeconomic status and only between categories of gender in the severe ETW analysis. Regarding overall extent of ETW, significant differences were found between categories of gender, socioeconomic status and the habit of swish before swallow. In regards to extent of severe ETW, significant variables were swish before swallow and brushing frequency. In the adjusted analysis, males (OR=3.22, 95%CI=1.50–6.89) and the consumption of yogurt ≥3 times a day (OR=3.98, 95%CI=1.18–13.47) were associated with the presence of severe ETW. The most frequently affected teeth were the upper incisors at the palatal surfaces followed by first molars (occlusal surfaces). Conclusions: The high prevalence suggests that ETW may be considered a public health problem among 12-year-old-Uruguaian schoolchildren. The increased risk among boys should be taken into account in the development of preventive strategies against ETW.