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1.
Artigo em Inglês | MEDLINE | ID: mdl-32414126

RESUMO

The aim of this pilot study was to describe the advantages of telemedicine (TM) in dental practice during the current national emergency condition due to the Covid-19 dissemination. At Department of Oral Surgery and Pathology-Magna Graecia University of Catanzaro, regional reference center for Covid-19-two groups of patients were determined: patients with urgent conditions (group U) and patients in follow-up (group F). Both groups were instructed to implement remote consultations using a messaging service (WhatsApp Messenger, WhatsApp Inc., Mountain View, California, USA) to send photos. A total of 418 photos were collected by 57 patients. Thirty-four photos were obtained by five patients in the U group after surgical procedures. All patients sent photos on the established evening, except for two patients who sent two photos outside the set days. In the F group, 384 photos were collected by 52 patients. None of them sent more photos than the number that was established by the protocol. Telemedicine allowed a monitoring of all patients, reducing costs and limiting human contact, decreasing the risk of Covid-19 dissemination.


Assuntos
Odontologia Comunitária , Infecções por Coronavirus , Serviços de Saúde Bucal/estatística & dados numéricos , Doenças da Boca/diagnóstico , Pandemias , Pneumonia Viral , Consulta Remota , Telemedicina , Adulto , Betacoronavirus , Coronavirus , Assistência à Saúde , Clínicas Odontológicas , Serviços de Saúde Bucal/organização & administração , Odontologia , Feminino , Humanos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Aplicativos Móveis , Projetos Piloto , Odontologia em Saúde Pública , Encaminhamento e Consulta , Adulto Jovem
2.
Prim Dent J ; 8(3): 64-74, 2019 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-31666174

RESUMO

In 2019, in a world of instant gratification, what are the expectations of patients and dentists? Is training sufficient to meet these expectations? Decision-making in dentistry impacts the treatment choices patients are given, and may influence the outcomes of such treatment. It is therefore important to ensure as much standardisation as possible. In order to achieve this, it is important to know the current standard and the views of dentist as this will influence dental treatment planning. Clinical Relevance: This paper captures the treatment planning dilemmas of dentists, specifically of those in their Foundation training year, in order to aid targeting of training and development. Objective Statement: To understand treatment decisions of general dental practitioners and specialists.


Assuntos
Assistência Odontológica/organização & administração , Serviços de Saúde Bucal/organização & administração , Odontólogos/psicologia , Odontologia Geral , Medicina Geral , Odontologia Geral/organização & administração , Humanos
3.
Worldviews Evid Based Nurs ; 16(5): 408-415, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31544360

RESUMO

PURPOSE: The purpose of this study was to examine the Oral Health-Related Quality of Life (OHRQOL) and Oral Health Impact Profile (OHIP) of oral and dental health patients in terms of gender, educational status, and the reason for coming to the oral health center. Also, we investigated the relationships between OHRQOL and OHIP. METHODS: This cross-sectional study was conducted and planned for dental patients in Turkey. OHRQOL-United Kingdom (OHRQOL-UK) and OHIP-14 were used for data collection. Descriptive statistics, correlation analysis, student t-tests, and ANOVA were used for data analyses. RESULTS: Of 527 respondents, 62.8% were female, and 37.2% were male. One-hundred-forty-one (26.8%) participants were illiterate. Three-hundred-fifty-four (67.20%) dental patients had an elementary school degree. Only 32 (6.10%) participants graduated from college and bachelor programs. For dimensions of the OHIP-14 and OHRQOL-UK, we detected statistically significant differences in personal characteristics. We found that gender, marital status, age, education status, and reasons for coming to the hospital have a significant impact on OHRQOL and OHIP. LINKING EVIDENCE TO ACTION: These results are expected to provide important evidence-based information to health managers and decision-makers in health planning and reimbursement policies. Clinicians and health managers should use OHIP, quality of life (QOL), and evidence-based practice to determine individual treatments and approaches to improve oral health. QOL is an outcome indicator in healthcare services and evidence-based practice. Measurements of evidence-based health outcomes in national health systems can be made, and global comparisons and policies in oral and dental health can be developed.


Assuntos
Prática Clínica Baseada em Evidências/normas , Resultado do Tratamento , Adulto , Estudos Transversais , Serviços de Saúde Bucal/organização & administração , Serviços de Saúde Bucal/normas , Serviços de Saúde Bucal/estatística & dados numéricos , Prática Clínica Baseada em Evidências/métodos , Prática Clínica Baseada em Evidências/estatística & dados numéricos , Feminino , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida/psicologia , Inquéritos e Questionários , Turquia
5.
Cien Saude Colet ; 24(5): 1809-1820, 2019 May 30.
Artigo em Português | MEDLINE | ID: mdl-31166514

RESUMO

Ensuring access to dental care services requires the development of healthsurveillance practices to ensure comprehensive health care. The objective of this study was toinvestigate the association between social and economic indicators of Brazilian municipalities, work process characteristics, and performance of a list of curative dental procedures by oral health teams. It involved an exploratory, cross-sectional study withmulticenter data collection from 11,374 oral health teams assessed by the National Program for Improvement of Access to and Quality of Primary Healthcare. Multilevel Poisson regression was used to obtain the prevalence of curative dental procedures, which was 69.51%. The social/economic and work variables that remained associated with the outcome included municipalities in which the proportion of primary care-sensitive admissions was below 28% and that of tooth extractions below 8%; and oral health teams classified as type II (including oral health assistant and technician) that had different materials available and better work processes. This multilevel analysis, which took into consideration the performance of curative dental care in Brazil, reveals a worrying oral healthcare scenario.


Assuntos
Assistência Odontológica/organização & administração , Serviços de Saúde Bucal/organização & administração , Equipe de Assistência ao Paciente/organização & administração , Atenção Primária à Saúde/organização & administração , Brasil , Assistência Integral à Saúde/organização & administração , Estudos Transversais , Serviços de Saúde Bucal/normas , Acesso aos Serviços de Saúde , Humanos , Programas Nacionais de Saúde/organização & administração , Saúde Bucal , Atenção Primária à Saúde/normas , Qualidade da Assistência à Saúde
6.
BMC Oral Health ; 19(1): 126, 2019 06 25.
Artigo em Inglês | MEDLINE | ID: mdl-31238976

RESUMO

BACKGROUND: User satisfaction represents a patient-centered measure that should be used to assess the quality of oral health services. This study investigated the differences in user satisfaction with public oral health services according to the sociodemographic user profile and the quality of oral health services in primary health care in Brazil. METHODS: Secondary data from a national program obtained through interviews with users were analyzed. Satisfaction was based on the Swan' model relating to perceptions regarding the service performance, assessment of overall satisfaction and the intention to avoid the service in the future. The exploratory variables were demographic characteristics of the users and the quality of the primary service from the user's viewpoint, considering the dimensions: access; receptivity of spontaneous demand; integral health care; bonding, accountability, and coordination of care. RESULTS: A total of 37,262 users participated, and 65.51% reported satisfaction with the oral health service, that was higher among those > 20 years old and beneficiaries of the Family Grant Program and lower among users with a higher level of schooling and those who reported being employed. Users who rated oral health service positively were more satisfied. CONCLUSIONS: Socioeconomically disadvantaged user was more satisfied with oral health services and the satisfaction increased with age. The improvement in the quality of oral health services in primary care can result in greater satisfaction.


Assuntos
Serviços de Saúde Bucal/organização & administração , Saúde Bucal , Satisfação do Paciente , Satisfação Pessoal , Atenção Primária à Saúde/organização & administração , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil , Estudos Transversais , Feminino , Acesso aos Serviços de Saúde , Pesquisa sobre Serviços de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade da Assistência à Saúde , Inquéritos e Questionários , Adulto Jovem
7.
BMJ Open ; 9(3): e024995, 2019 03 23.
Artigo em Inglês | MEDLINE | ID: mdl-30904857

RESUMO

OBJECTIVES: To understand approaches to priority setting for healthcare service resource allocation at an operational level in a nationally commissioned but regionally delivered service. DESIGN: Qualitative study using semistructured interviews and a Framework analysis. SETTING: National Health Service dentistry commissioning teams within subregional offices in England. PARTICIPANTS: All 31 individuals holding the relevant role (dental lead commissioner in subregional offices) were approached directly and from this 14 participants were recruited, with 12 interviews completed. Both male and female genders and all regions were represented in the final sample. RESULTS: Three major themes arose. First, 'Methods of priority setting and barriers to explicit approaches' was a common theme, specifically identifying the main methods as: perpetuating historical allocations, pressure from politicians and clinicians and use of needs assessments while barriers were time and skill deficits, a lack of national guidance and an inflexible contracting arrangements stopping resource allocation. Second, 'Relationships with key stakeholders and advisors' were discussed, showing the important nature of relationships with clinical advisors but variation in the quality of these relationships was noted. Finally, 'Tensions between national and local responsibilities' were illustrated, where there was confusion about where power and autonomy lay. CONCLUSIONS: Commissioners recognised a need for resource allocation but relied on clinical advice and needs assessment in order to set priorities. More explicit priority setting was prevented by structure of the commissioning system and standard national contracts with providers. Further research is required to embed and simplify adoption of tools to aid priority setting.


Assuntos
Serviços de Saúde Bucal , Alocação de Recursos para a Atenção à Saúde , Pessoal Administrativo , Serviços de Saúde Bucal/economia , Serviços de Saúde Bucal/organização & administração , Inglaterra , Alocação de Recursos para a Atenção à Saúde/métodos , Alocação de Recursos para a Atenção à Saúde/organização & administração , Prioridades em Saúde/organização & administração , Humanos , Determinação de Necessidades de Cuidados de Saúde , Pesquisa Qualitativa , Regionalização/métodos , Medicina Estatal
8.
Cien Saude Colet ; 24(3): 953-961, 2019 Mar.
Artigo em Português, Inglês | MEDLINE | ID: mdl-30892516

RESUMO

The goal was to assess the access and factors connected to dental visits in children up to age five in the city of Porto Alegre, Brazil. The cross-sectional study was conducted in 10 Basic Health Units through a questionnaire and clinical examination on 560 children. Clinical (visible plaque, gingival bleeding and defs), socio-demographic, and visit access variables were assessed. Poisson Regression was used to calculate the Prevalence Ratios (PR), with a 95% confidence interval. Results showed that 68.2% of children had never gone to a dentist. The main reason reported for not visiting a dentist was not feeling the need (48.7%) and difficult access to a health clinic (15.8%). The purpose of going to the dentist was for prevention/revision (55.8%), and the most sought-after places for visits were the private office (43.9%) and health clinic (39.5%). The final multivariate model showed that age of the child (95%CI, PR = 1.03 (1.02-1.05)), household income (PR = 1.05; (1.01-1.08)), and the mother having completed high school (PR = 1.69 (1.15-2.56)) were associated with seeking dental consultation. Thus, it is crucial to recognize the importance of the family setting during the first years of life.


Assuntos
Assistência Odontológica para Crianças/estatística & dados numéricos , Serviços de Saúde Bucal/estatística & dados numéricos , Acesso aos Serviços de Saúde , Saúde Bucal/estatística & dados numéricos , Adulto , Fatores Etários , Brasil/epidemiologia , Pré-Escolar , Estudos Transversais , Serviços de Saúde Bucal/organização & administração , Placa Dentária/epidemiologia , Escolaridade , Feminino , Hemorragia Gengival/epidemiologia , Humanos , Renda , Lactente , Masculino , Análise Multivariada , Distribuição de Poisson , Inquéritos e Questionários , Adulto Jovem
9.
Aust Dent J ; 64(1): 55-65, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30375645

RESUMO

BACKGROUND: Pregnant women in Australia seldom seek dental care and are unaware of its importance. To address these gaps the midwifery-initiated oral health dental service (MIOH-DS) program was comprehensive trialled and found effective. The aim of this study was to undertake a process evaluation of the MIOH-DS using the perspectives of pregnant women who participated in the trial. METHODS: A qualitative research design was utilized, whereby content analysis was undertaken on data from 11 semi-structured interviews with women who participated in the program. RESULTS: All participants were receptive of the MIOH-DS intervention, and found it to be an acceptable intervention that met their needs, and encouraged future positive oral health practices and health-seeking behaviours. They expressed that midwives were an appropriate professional to conduct oral health assessments, education and referrals to affordable dental services. Although some participants were initially apprehensive towards receiving treatment during pregnancy, dental staff members were able to appropriately educate and reassure them during treatment. CONCLUSIONS: The MIOH-DS represents a promising and acceptable intervention strategy for pregnant women to promote their oral health. Findings merit further investigation on whether positive outcomes achieved can be sustained when implemented in other national or international settings similar to the study setting.


Assuntos
Serviços de Saúde Bucal/organização & administração , Tocologia , Saúde Bucal , Aceitação pelo Paciente de Cuidados de Saúde , Austrália , Feminino , Humanos , Tocologia/organização & administração , Gravidez , Avaliação de Programas e Projetos de Saúde , Encaminhamento e Consulta
11.
Rio de Janeiro; s.n; 2019. 232 f p. fig, tab, graf.
Tese em Português | LILACS | ID: biblio-998336

RESUMO

Esta tese tem como objeto analisar a Política Nacional de Saúde Bucal (PNSB) e a sua conexão com a Rede de Cuidados à Pessoa com Deficiência (RCPD) no estado do Amazonas. Para compreender a configuração da Política e a transversalidade com a Rede nessa localidade, os processos de pesquisa foram delineados para o cerne dessa questão e o enfoque dos referenciais teóricos e levantamento de dados obtidos a partir desse direcionamento. Os encaminhamentos metodológicos partiram de duas frentes de busca - configuração da Política e atenção à saúde bucal às pessoas com deficiência (PcD) no Amazonas, nos três níveis de atenção. Desta forma os dados foram coletados através dos bancos de dados oficias do governo federal - Sistemas de Informações Ambulatoriais (SIA/SUS), Sistema de Informações Hospitalares (SIH/SUS) e Cadastro Nacional de Estabelecimentos de Saúde (CNES), todos do Departamento de Informática do Sistema Único de Saúde (DATASUS), através das ferramentas TABNET e TABWIN. Os resultados das pesquisas verificaram que este estado possui os mesmos problemas de ordem nacional que os demais estados brasileiros, somados ao desfavorecimento regional e aos problemas locais, a falta de infraestrutura associada ao isolamento geográfico e político, a grande dispersão populacional e a dificuldade de locomoção são características peculiares desse estado. Além de existirem grandes desigualdades socioeconômicas entre os municípios amazonenses, expressas pela desigualdade de renda no Amazonas (maior que no Brasil) e pelos indicadores sociais insatisfatórios (40,3% dos municípios têm Índice de Desenvolvimento Humano (IDH) baixo e o estado possui o progresso social baixo ­ Índice de Progresso Social IPS/54,92). Essas adversidades não podem ser tratadas de maneira singular e, por consequência, esse estado demanda atenção diferenciada com necessidade de investimentos em diversos setores, incluindo a saúde. A configuração da PNSB está fortemente concentrada na cidade de Manaus, principalmente no que diz respeito a atenção terciária, pois os dois hospitais aderidos à RCPD estão localizados nessa cidade. A atenção à saúde bucal, na atenção básica (AB), no Amazonas, apresenta baixa cobertura populacional tanto no estado (36,1%) quanto na capital (14,0%), refletindo em baixo acesso à saúde bucal individualizada. E a lógica do SIA/SUS não permite separar a população individualmente, o que prejudica o planejamento, programação, regulação, avaliação, controle e auditoria dos serviços ambulatoriais de saúde bucal para as PcD na AB. Na média complexidade, constatamos que dos 62 municípios amazonenses apenas nove (14,5%) possuem oferta da atenção à saúde bucal especializada, sendo 13 Centros de Especialidades Odontológicas (CEO) no estado, o que significa que 35% da população do Amazonas (1.427.527 habitantes), encontra-se desassistida da atenção à saúde bucal nesse nível de atenção. Sendo assim apresentamos algumas sugestões com o intuito de aprimorar a PNSB e a atenção à saúde bucal das PcD


This thesis aims to analyze the National Oral Health Policy (PNSB) and its connection to the Care Network for the Disabled Person (RCPD) in the state of Amazonas. In order to understand the configuration of the Policy and the transversality with the Network in that locality, the research processes were delineated to the core of this issue and the focus of the theoretical references and data collection obtained from this targeting. The methodological guidelines started from two fronts of search - configuration of the Policy and Oral Health Care for People with Disabilities (PwD) in Amazonas, in the three levels of attention. In this way the data were collected through the official databases of the federal government - Outpatient Information Systems (SIA/SUS), Hospital Information System (SIH/SUS) and National Registry of Health Establishments (CNES), all from the Department of Informatics of the Unified Health System (DATASUS), through the tools TABNET and TABWIN. The results of the surveys verified that this state has the same problems of national order as other Brazilian states, together with regional disadvantage and local problems: the lack of infrastructure associated with the geographical and political isolation, a large population dispersion and the difficulty of locomotion are peculiar characteristics of this state. In addition to the large socioeconomic inequalities between Amazonas municipalities, expressed by income inequality in Amazonas (higher than in Brazil) and by unsatisfactory social indicators (40.3% of municipalities have a low Human Development Index (HDI), and the state has low social progress - Social Progress Index IPS/54,92). These adversities cannot be treated in a singular way and, as consequence, this state demands differentiated attention with the need of investments in several sectors, including health. The configuration of the PNSB is strongly concentrated in the city of Manaus, especially regarding tertiary care, as the two hospitals adhered to RCPD are located in that city. The oral health care in primary care (AB) in Amazonas has low population coverage in both the state (36.1%) and the capital (14.0%), reflecting low access to individualized oral health. And the SIA/SUS logic doesn't allow the separation of the individual population, which impairs the planning, programming, regulation, evaluation, control and audit of outpatient oral health services for the PwD in AB. In terms of complexity, we found that only nine (14.5%) of the 62 municipalities of Amazonas have specialized oral health care, 13 of which are Dental Specialty Centers (CEO) in the state, which means that 35% of the Amazonas population (1.427.527) is disassociated from oral health care at this level of care. Thus, we present some suggestions with the aim of improving the PNSB and the oral health care of PcD


Assuntos
Humanos , Atenção Primária à Saúde , Sistema Único de Saúde , Brasil , Saúde Bucal , Pessoas com Deficiência , Assistência Odontológica para Pessoas com Deficiências/organização & administração , Serviços de Saúde Bucal/organização & administração , Política de Saúde
12.
Braz Dent J ; 29(5): 500-506, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30517450

RESUMO

This study describes the structure of oral health services in primary health care in Brazil and the instruments available for the provision of oral health care and to compare the number of instruments according to organizational characteristics of health services and among the macroregions. Of the 23,251 oral health teams (OHTs) in the Public Health System, 17,513 (75.3%) participated in this study. Trained researchers observed the structures of the health services and determined the presence of and whether a sufficient quantity of 36 dental instruments existed. The score of each oral health service was determined by the sum of the number of dental instruments present in sufficient quantity (0 to 36). Central tendency measures were compared along with the variability in these scores according to the organizational characteristics of the services and according to the Brazilian macroregion. No instrument was found to be present in all evaluated services. Basic, surgical and restorative instruments were the most frequently found. Periodontal, endodontic and prosthetic instruments exhibited the lowest percentages. The mean and median numbers of dental instruments were higher for teams that operated over more shifts, those with an oral health technician and those in the South and Southeast regions. The oral health services were equipped with basic, surgical and restorative instruments. Instruments designed for periodontal diagnosis, emergency care and denture rehabilitation were less frequently found in these services. The worst infrastructure conditions existed in the OHTs with the worst forms of care organization and in regions with greater social issues.


Assuntos
Serviços de Saúde Bucal/organização & administração , Instrumentos Odontológicos/estatística & dados numéricos , Atenção Primária à Saúde , Brasil , Humanos , Inquéritos e Questionários
14.
Cien Saude Colet ; 23(11): 3957-3964, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30427465

RESUMO

It aims to evaluate the association between dental appearance and Oral Health Related Quality of Life. Fifteen primary care services with dental services were selected in Porto Alegre, Brazil. Individuals were interviewed from a random sampling of households in the catchment area of the health centres. The outcome was having an OHIP14 score > 0 (any impact). The main exposures included self-reported tooth colour and position, perception of oral health and concern with dental aesthetics. Data were analysed with stepwise logistic regression. Of 1943 individuals contacted, 433 used public dental services in the last year. Seventy-three percent had some impact on quality of life, 35.2% and 47.5% reported stained and crowded teeth, respectively. Also, 22.2% had already tried bleaching their teeth. Individuals concerned with colour were 2.56 times (95% CI: 1.34-4.89) more likely to report any impact after adjusting for number of teeth, smoking and education. Concerns about tooth position, reporting stained or crowded teeth, age, sex and income were not significant (p > 0.30). There is a direct and independent association between concerns with tooth colour and quality of life. The effect of tooth colour on quality of life may be mediated by individuals' perceptions of aesthetics.


Assuntos
Má Oclusão/psicologia , Saúde Bucal , Qualidade de Vida , Descoloração de Dente/psicologia , Adolescente , Adulto , Brasil , Serviços de Saúde Bucal/organização & administração , Estética Dentária/psicologia , Feminino , Humanos , Entrevistas como Assunto , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Satisfação Pessoal , Atenção Primária à Saúde/organização & administração , Adulto Jovem
18.
N C Med J ; 79(4): 235-239, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29991615

RESUMO

In North Carolina, our public health infrastructure consists of a state health department and 85 local health departments representing all 100 counties. The state health department, local health departments, health systems, and clinical providers work literally and figuratively as a team to improve the health of our citizens. In this article, we provide examples of the critical role of public health practitioners as part of the broader team addressing health, specifically in the areas of chronic disease, communicable disease, oral health, environmental health, and maternal and child health.


Assuntos
Doença Crônica/prevenção & controle , Equipe de Assistência ao Paciente/organização & administração , Saúde Pública , Controle de Doenças Transmissíveis/organização & administração , Serviços de Saúde Bucal/organização & administração , Humanos , Serviços de Saúde Materno-Infantil/organização & administração , North Carolina
20.
Braz Dent J ; 29(2): 154-158, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29898061

RESUMO

This study investigated risk factors for tooth injuries in individuals from a dental clinical reference service for patients with special needs in Belo Horizonte, MG, Brazil. This is a retrospective cohort study that evaluated 493 dental charts of individuals with or without tooth injuries at their first dental appointment. The dependent variable was the time of occurrence of new dental traumatic injuries and was measured in months. Gender, age, International Code of Diseases, mother's education, mouth breathing, hyperkinesis, pacifier use, thumb sucking, psychotropic drug use, tooth injuries at the first dental examination, involuntary movements, open bite, having one or more siblings and reports of seizures were the covariates. The Cox proportional hazards regression model was used to estimate the unadjusted and adjusted hazard ratios and their respective 95% confidence intervals. The average time that individuals remained free of dental traumatism was 170.78 months (95% CI, 157.89-183.66) with median of 216 months. The incidence of new events was 11.88%. The covariate associated with an increased risk of dental traumatism was a history of tooth injuries at the first dental appointment. The increase in dental trauma risk was 3.59 (95% CI, 1.94-6.65). A history of traumatic dental injury was the risk factor for the dental trauma found in this group of individuals with developmental disabilities.


Assuntos
Assistência Odontológica para Pessoas com Deficiências , Deficiências do Desenvolvimento/epidemiologia , Traumatismos Dentários/epidemiologia , Adolescente , Adulto , Brasil/epidemiologia , Criança , Pré-Escolar , Serviços de Saúde Bucal/organização & administração , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Prevalência , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Fatores de Risco , Traumatismos Dentários/terapia , Adulto Jovem
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