Experience report on the training of Brazilian dental managers using active methodologies

This is an account on the training of dental managers in a Social Welfare, not-for-profit, non-governmental institution present in all Brazilian states. Given the continental dimension of Brazil, its regional inequalities and the need for uniformity in the management conduct, as well as in the planning and evaluation of services, it is understood that developing managers' skills and competences is fundamental. Bearing in mind that the model adopted by the company is based on collective health, and its structure is organized in Primary Care, this proposal can be applied by other organizations that offer services of a similar nature. The aim of this study is to describe the training of oral health managers (n = 54) on the themes of sustainability, practices based on evidence/health economics and social determinants - themes that were requested by the managers themselves. Using problem-based learning, active and distance-learning methodologies, three working groups were set up among the managers to go through the contents of the training program, which aimed at training mentors and identifying successful service experiences for sharing. This process peaked at a face-to-face session with all participants where a specialist and their respective mentors presented each topic. The products obtained were: (1) three scientific-economic studies for decision making on the incorporation of hard technologies; (2) a guide to sustainable practices in dentistry and (3) a set of criteria for prioritizing access based on social determinants. In the evaluation of the training, 89% of managers were very satisfied, 8.98% were satisfied and 1.79% were dissatisfied. It is concluded that the methodology used in this process significantly contributed to the development of the company's regional service managers and such improvement stemmed from the empowerment, engagement and alignment of these managers, to which action plans were directed, with measures for monitoring and evaluation.

Key messages

Active methodologies in training contributes to the empowerment, engagement and alignment of dental managers before epidemiological, economic and social challenges faced in the management of services. Trainings where the participants are protagonists in all stages of the educational processes, are those that produce the best results and the highest degree of satisfaction among employees.

Satellite Remote Sensing: A Tool to Support Harmful Algal Bloom Monitoring and Recreational Health Advisories in a California Reservoir

Cyanobacterial harmful algal blooms (cyanoHABs) can harm people, animals, and affect consumptive and recreational use of inland waters. Monitoring cyanoHABs is often limited. However, chlorophyll-a (chl-a) is a common water quality metric and has been shown to have a relationship with cyanobacteria. The World Health Organization (WHO) recently updated their previous 1999 cyanoHAB guidance values (GVs) to be more practical by basing the GVs on chl-a concentration rather than cyanobacterial counts. This creates an opportunity for widespread cyanoHAB monitoring based on chl-a proxies, with satellite remote sensing (SRS) being a potentially powerful tool. We used Sentinel-2 (S2) and Sentinel-3 (S3) to map chl-a and cyanobacteria, respectively, classified chl-a values according to WHO GVs, and then compared them to cyanotoxin advisories issued by the California Department of Water Resources (DWR) at San Luis Reservoir, key infrastructure in California's water system. We found reasonably high rates of total agreement between advisories by DWR and SRS, however rates of agreement varied for S2 based on algorithm. Total agreement was 83% for S3, and 52%-79% for S2. False positive and false negative rates for S3 were 12% and 23%, respectively. S2 had 12%-80% false positive rate and 0%-38% false negative rate, depending on algorithm. Using SRS-based chl-a GVs as an early indicator for possible exposure advisories and as a trigger for in situ sampling may be effective to improve public health warnings. Implementing SRS for cyanoHAB monitoring could fill temporal data gaps and provide greater spatial information not available from in situ measurements alone.