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HOW THE CEDROS NETWORK WORKS


The CEDROS Network does not intend to be a new institution in the dental area, but rather a mechanism to allow the joint actions of individuals in institutions, searching the improvement of the oral health status of the Brazilian population. Thus being, the organizational structure of the Network aims at adequate to this basic feature, trying to make it "the lighter and faster" possible, horizontally and not hierarchically.

Working Groups

The Network is structured in Working Groups (WGs) created with basis on specific problems. Presently there are five working groups in development:

WG 1. Mass methods for caries prevention

We have two work lines in this group: sanitary vigilance as to the water fluoridation and development of an index-area for salt fluoridation. The first line aims at contributing to the structure of the sanitary vigilance and water fluoridation systems, in the places where these measures are adopted. The Group will produce a technical manual to instruct the City Halls, providing theoretical support for the installation of this kind of system. The coordination of this line will be responsibility of Drs. Paulo Capel Narvai, of the Public Health School of the University of São Paulo, and Douglas Schneider - Assistant for Oral Health of the Health Municipal Secretariat of São Paulo, who have been successfully performing since January 1990 a system of monthly evaluation of fluoride concentration in the supplying water of that capital. The second work line is related to the strengthening and development of the project index-area of salt fluoridation in Cabo Frio, already started last March (see page 5). The studies will go on with special attention to the education of the community concerning the measure, quality control of the product in the market, and monitoring of fluoride excretion in the population. Prof. Helio Uchôa, of the Dental School of UERJ, is responsible for this line.

WG 2. Self-care, health promotion and communitary participation

It is known today that the fluoridated toothpastes, used correct and regularly, are a powerful weapon to fight dental caries. It is also known that this method increases the results achieved by means of water fluoridation or salt fluoridation. Therefore, the CEDROS Network has created a special work line on self-care. A special project is already working in an area next to the UFRJ, with strong communitary participation and utilization of communitary health promoters. A similar project is being developed in Anapolis, Goias. We hope, in this next period, to enlarge the work and to constitute a work group within the line of self-care. Dr. Roberto Vianna, of the Dental School of UFRJ, will be in charged for that.

WG 3. Stomatology

This area involves mainly questions related to Oral Cancer and AIDS. We will start the works with AIDS, which is presently one of the most serious problems for dental professionals. Multiprofessional groups have been formed in universities and hospitals in several states of Brazil, worried specifically about the repercussion of the problem in the dental practice. The Network's idea is to create a multi-institutional work group in order to develop the following components of an AIDS program in Dentistry:

a. standardized systems for data collection, using WHO methodology

b. infections control

c. oral manifestations of AIDS

d. control of HIV patients, with or without symptoms, in dental offices.

As initial product, a manual will be prepared to instruct dentists on the subjects above. The group will be coordinated by Prof. Abel Cardoso and Sonia Ferreira, of UFRJ, and Sandra Torres, of Fluminense Federal University (UFF).

WG 4. Undergraduate teaching

IN this area we have two Work Lines, one of curriculum and articulation teaching-service, and other of innovation in educational technologies. The first line refers to the continuity of the work developed by the São Paulo and Rio Nodes in the first year of the Network. We will have as a reference the two meetings held, two in São Paulo and one in Rio (see pages 4 and 5). The coordination of this work line will be of Prof. José Roberto Bastos, of the Dental School of Baurú - USP. The second line is a new area, which will join people interested in teaching development based on competencies, and on the performance evaluation of the student in these areas. This will result in a period of teaching by competencies, which will be liable to occur in clinical departments and extend gradually to other departments. Prof. Hilton Souchois, of the Dental School of UERJ, is in charge of this coordination.

WG 5. Management of the dental component of the Health Local Systems (SILOS)

The implementation of the Unique Health System in our country, according to the new Constitution, demands a redefinition of the way the dental services must be planned, executed and evaluated in the basic organizational cores of this System, which are the Health Local Systems (SILOS). As a Work Line in this area, a joint effort will be coordinated in order to develop dental attention models for the community. The leaders of this group will be Drs. Sylvio Gevaerd, of the Center of Communitary Health Studies of the Federal University of Paraná (UFPR) and Douglas Schneider, of the Health Municipal Secretariat of São Paulo.

Supporting Systems

With the purpose of providing support to the Working Groups, Supporting Systems (SSs) were structured to develop some areas of common interest, which are:

SS 1. Epidemiology

The first work of this group was the translation of the WHO Manual on Basic Epidemiological Surveys in Oral Health (see page 5). For the next period we have planned the elaboration of a manual for calibration of researchers, aiming at the standardization of the techniques. This will allow higher reliability and comparability of the data collected. Another special work will be performed with the index to measure periodontal problems (CPITN). This work will involve inquiries which will serve simultaneously for the index practice and for the calibration of researchers, and also as a description of the status of periodontal disease among us. A millimetered probe for measuring the CPITN is already available in the market and is manufactured here in Brazil. IT costs less than 3 dollars and was developed according to the technical instructions of the CEDROS Network. A manual dealing with fluorosis will also be prepared, considering the importance of the subject for public health and the absence of literature concerning it. Prof. Luiz Octavio Guimarães will be responsible for this work.

SS 2. Bibliographic Information

The work line of bibliographic information is oriented towards the enrichment and modernization of the Brazilian dental libraries by means of a system developed by the Dental School of USP, which owns the best dental library in the country. The USP library has close relation with BIREME, in São Paulo, and serves as a support in the Dental area. Both BIREME and the Dental School of USP have recently received funds from the Kellogg Foundation for projects in the area of information systems. We hope, within this work line, to collaborate in the establishment of a network of dental information centers that could at the same time to benefit from the support of the USP library, and to serve as subcenters of the CEDROS Network. The subcenters will produce detailed information which will be disseminated selectively according to the work lines of CEDROS. This relation will result in the participation of dental teachers and librarians in a common effort to improve the bibliographic information in the dental area in Brazil. Prof. Rozaly Krzyzanowski, Technical Director of the Service of Dental Documentation of the Dental School of USP/São Paulo, will lead this work.

SS 3. Evaluation

This work line is not explicitly contained in the areas initially foreseen, because our idea is that it serves as a support for all the others, since the development of creative and innovative methodologies for oral health demands meticulous planning and evaluation of methodologies used.

This will serve to evaluate the activities of the WHO Collaborating Center, of the Pole IV of OFEDO/Networks Project and of each one of the work lines of CEDROS at the end of each year.

Knowledge will be required in the areas of educational evaluation, health services evaluation, and in a particularly important area such as the technologies evaluation.

The Executive Secretariat of the Network will conduct the works in this area.

SS 4. Communications and Dissemination of Information

The Executive Secretariat of CEDROS has a data processing center able to establish communications via Bitnet with a great number of Brazilian and foreign universities. It still has exclusive lines of fax and phone, and post office box, in order to make communications easier. The CEDROS Network has its own data bank, with a great number of names and addresses of participants of the meetings, who often receive all the needed information rapid and safely.

Executive Secretariat

As an element to link and make feasible the projects of the network, there is an Executive Secretariat located in the COPIPED, UFRJ, being Dr. Thomaz Chianca the Executive Secretary.

Development Nodes

To coordinate and dynamize the works regionally, there are presently two nodes, the Rio and the São Paulo ones, located respectively at the Dental School of UERJ, coordinated by Dr. Hilton Souchois, and at USP/Baurú, coordinated by Dr. Eymar Sampaio. We expect the creation of another Node still this year, in a state of the northeast.

Coordinating Board

The general coordination of the Network, responsible for the strategic conduction of the work nationally, is organized under the form of a board, compounded by Profs. Roberto Vianna, Mário Chaves and Thomaz Chianca (UFRJ), Luiz Octávio Guimarães and Eymar Sampaio (USP), Hilton Souchois and Hélio Uchôa (UERJ).


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