Use of Telehealth technologies in Mais Médicos Program ­ Espírito Santo, 2016 / Uso de tecnologias de Telessaúde por médicos do Programa Mais Médicos e fatores associados ­ Espírito Santo, 2016

Telehealth is key to primary health care qualification. There is no knowledge about its use in the Mais Médicos Program. Here, we sought to analyze the use of Telehealth tools at Mais Médicos in Espírito Santo state in 2016. This is a cross-sectional study with a structured questionnaire applied to the total number of physicians present at regional telehealth seminars. The analysis included absolute and relative frequency and bivariate analysis with Fisher's exact test. As a result, 211 doctors (48.6% of the total number of professionals at Mais Médicos) participated. The majority were Cubans who worked in a large urban center with a specialization in Family and Community Medicine. Most (n=130, 61.9%) had already used some Telehealth service, but discontinuously, with Tele-education being the most used (n=101; 77.7%). Getting to know Telehealth and its tools and seeing them as relevant to improving the service were associated with greater use of technologies. The facility and type of device used to access the internet do not influence the use of the program. It is concluded that the knowledge and relevance given to Telehealth tools by professionals and their work context are more associated with their use than structural working conditions.

Telessaúde é uma das estratégias de qualificação da atenção primária. Não há trabalho que analise sua utilização no Programa Mais Médicos. Logo, buscou-se analisar a utilização das ferramentas de Telessaúde no Mais Médicos do estado Espírito Santo em 2016. Trata-se de um estudo transversal com aplicação de questionário estruturado ao total de médicos presentes em seminários regionais em Telessaúde. A análise incluiu frequência absoluta e relativa e análise bivariada com teste exato de Fisher. Como resultado, 211 médicos (48,6% do total de profissionais do Mais Médicos) participaram, sendo a maioria cubanos que atuavam em grande centro urbano com especialização em Medicina de Família e Comunidade. A maior parte (n=130, 61,9%) já havia utilizado algum serviço de Telessaúde, mas de forma descontínua, sendo a teleducação o mais utilizado (n=101; 77,7%). Conhecer o Telessaúde e suas ferramentas e vê-las como relevantes para a melhoria do serviço se associaram a maior uso das tecnologias. A facilidade e o tipo de dispositivo utilizado para acessar a internet não influenciam a utilização do programa. Conclui-se que o conhecimento e a relevância dada às ferramentas de Telessaúde pelos profissionais e seu entorno estão mais associadas a seu uso que as condições estruturais de trabalho.

[Influence of different concentrations of fluoride in the water on epidemiologic indicators of oral health/disease]. / Influência de diferentes concentrações de flúor na água em indicadores epidemiológicos de saúde/doença bucal.

The scope of this study was to evaluate access to fluoride sources and oral health hygiene of 237 schoolchildren aged nine to sixteen, from three locations with different fluoride concentrations in the water. The fluoride level in the water of each area was analyzed by the selective electrode technique for the fluoride ion and the prevalence of dental caries and fluorosis were evaluated, respectively, by the DMFT and TSIF index, revealing a statistically significant difference (ANOVA; p <0,05) in the three locations: area without artificial fluoridation (DMTF 5.32 ± 3.49) and 16% of dental fluorosis; area with artificial fluoridation of 0.8 ppmF (DMTF 1.88 ± 2.22) and 94% of dental fluorosis; area with natural fluoridation of 2.54 ppmF (DMTF 3.96 ± 2.38) and 100% of dental fluorosis. The findings suggest that the epidemiologic indicators of oral health/disease are influenced by the presence of fluoride in the water supply and that supervision and orientation are fundamental in the correct use of fluoridated compositions, taking advantage of the maximum benefit in the control of dental caries with minimum risk of the occurrence of dental fluorosis.

[Community Health Agent: status adapted with Family Health Program reality?]. / Agente comunitário de saúde: perfil adequado a realidade do Programa Saúde da Família?

This study analyses the status and work reality of Community Health Agents, with the purpose of contributing to the improvement of the Brazilian Health System (SUS) in small cities. It was discussed aspects related to their participation in the team of the Family Health Program (PSF) and their interaction with the community. It was observed a lack of motivation and experience, which compromises the quality of Agents performance in the community. It is known that these findings are reflex and consequence of an established context. It is necessary the team rethink their practice, specially the managers, having always as a fundament the principles that guide the SUS and PSF.

Length of resin tags in pit-and-fissure sealants: all-in-one self-etching adhesive vs phosphoric acid etching.

PURPOSE: To investigate the penetration (tags) of adhesive materials into enamel etched with phosphoric acid or treated with a self-etching adhesive, before application of a pit-and-fissure sealant. MATERIALS AND METHODS: The sample comprised six study groups with six specimens each. Before pit-and-fissure sealing with the materials Clinpro SealantTM (Groups I and II), Vitro Seal ALPHA (Groups III and IV) and Fuji II LC (Groups V and VI), the teeth in Groups I, III, and V were etched with 35% phosphoric acid for 30 seconds. Teeth in Groups II, IV, and VI received application of the self-etching adhesive Adper Prompt L-Pop. The treated teeth were sectioned buccolingually, ground to 100-microm thickness, decalcified, and analyzed by conventional light microscopy at 400x magnification. RESULTS: The teeth etched with phosphoric acid exhibited significantly greater penetration than specimens treated with self-etching adhesive. CLINICAL SIGNIFICANCE: When compared with enamel treated with a self-etching adhesive, the penetration (tags) of adhesive materials into enamel was greater when applied on enamel etched with phosphoric acid.