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PubMedDate not supplied

[The Mexican Institute of Social Security Institute (IMSS) in Numbers. Functional inventory of imaging medical equipment, 2003].

Medical technology is a fundamental instrument for the provision of health services in the Mexican Institute of Social Security (IMSS) and as a support for diagnostic and therapeutic interventions. The inventory of relevant medical equipment describes the needs for upgrading the technological infrastructure, organize its distribution and plan its renovation in order to guarantee the quality of health services. In this report we describe the type of equipment used in radiology and other imaging services, its geographical distribution, median age in operation and its productivity. The inventory reported 2091 pieces of equipment, ultrasonography and radiology were the most common types (31%) followed by fluoroscopic equipment (20%). Follow-up in the inventory should help in planning the acquisition and maintenance of sophisticated technology used for medical purposes.

Diagnostic Imaging↗
PubMed1982

[Training as an institutional function: institutional transformation experience by the Paraná Sanitary Company].

The experience of the Companhia de Saneamento do Paraná (SANEPAR) in recent years show that it is possible for a public service enterprise to operate on the entrepreneurial lines of a private business. For it to do this, it must start out with an awareness of entrepreneurial values and by creating an atmosphere that is congenial at the same time to the service mentality, motivation, the realization of individual potential, and efficiency. When the entrepreneurial values to be espoused have been defined and translated into concrete and measurable targets, incentives must be provided. In consequence of measures of this kind, SANEPAR has undergone a distinct institutional transformation whose concrete results are visible and measureable. A central feature of this transformation has been the broad participation and consequent involvement of the employees in the fate of the organization. Because of this involvement and the importance given to human resources, it became necessary to formulate and carry out an extensive personnel development program, in which training has come to the forefront as a means for stimulating and accelerating the realization of human potential. The measures taken have proved highly valid and have indelibly stamped the organization with the values and mentality of service. The assimilation of entrepreneurial values and the motivation and training of the employees has brought about real conditions for the growth and development of the entire organization.

Brazil↗
PubMed2005

The invisible barrier: literacy and its relationship with oral health. A report of a workgroup sponsored by the National Institute of Dental and Craniofacial Research, National Institute of Health, U.S. Public Health Service, Department of Health and Human Services.

Although oral health in the United States has improved significantly over time, preventable and treatable oral diseases remain common, especially among the poor and underserved. Limited literacy skills among adults are hypothesized to be one of many barriers to better oral health outcomes. Adults must be able to understand, interpret, and act on health information, whether it is communicated in spoken or in written form, to maintain their oral health and manage disease. While the body of health literacy research has grown in recent years, little is known about oral health literacy. Research is needed to build an understanding of oral health literacy and its impact on a variety of outcomes, including adoption of effective disease prevention regimens and actions, adherence to treatment regimens, effectiveness of caregivers and ultimately, improved oral health status. In addition, the effect of oral health literacy on the validity of clinical research such as response to surveys and adherence to research protocols is another area that is important to investigate. This paper defines oral health literacy and offers a framework for studying relationships between oral health literacy and other points of intervention for improving health outcomes. Findings of existing health literacy research are summarized, and a research plan for oral health literacy is proposed. A broad-based collaborative effort will be required to develop a detailed agenda for research, one that is aimed at reducing literacy barriers to oral health and ensuring that the information and insights emanating from new oral health research are more widely adopted.

Adult↗
PubMed2006

Pre-hospital 12-lead electrocardiography programs: a call for implementation by emergency medical services systems providing advanced life support--National Heart Attack Alert Program (NHAAP) Coordinating Committee; National Heart, Lung, and Blood Institute (NHLBI); National Institutes of Health.

Emergency medical services (EMS) providers who administer advanced life support should include diagnostic 12-lead electrocardiography programs as one of their services. Evidence demonstrates that this technology can be readily used by EMS providers to identify patients with ST-segment elevation myocardial infarction (STEMI) before a patient's arrival at a hospital emergency department. Earlier identification of STEMI patients leads to faster artery-opening treatment with fibrinolytic agents, either in the pre-hospital setting or at the hospital. Alternatively, a reperfusion strategy using percutaneous coronary intervention can be facilitated by use of pre-hospital 12-lead electrocardiography (P12ECG). Analysis of the cost of providing this service to the community must include consideration of the demonstrated benefits of more rapid treatment of patients with STEMI and the resulting time savings advantage shown to accompany the use of P12ECG programs.

Angioplasty, Balloon, Coronary↗
PubMed1992

Use of multiple-cause mortality data in epidemiologic analyses: US rate and proportion files developed by the National Institute for Occupational Safety and Health and the National Cancer Institute.

The authors have created US mortality rates (age, sex, race, and calendar-time specific) and proportions, using multiple cause-of-death data, for the years 1960-1989. Multiple cause-of-death data include the usual underlying cause of death from the death certificate as well as contributory causes and other significant conditions. US multiple-cause rates and proportions enable the user to calculate the expected occurrences of disease on the death certificates of a cohort under study. There is an average of 2.66 causes and/or contributory conditions listed on US death certificates, increasing over time from 2.54 in the 1960s to 2.76 in the 1980s. The ratio of multiple-cause listings to underlying cause listings varies by disease, from low ratios for cancers to high ratios for diseases such as diabetes, arthritis, prostate disease, hypertension, pneumoconiosis, and renal disease. Use of these data is illustrated with two cohorts. Multiple-cause analysis (but not underlying cause analysis) revealed twofold significant excesses of renal disease and arthritis among granite cutters. For workers exposed to dioxin, neither multiple-cause nor underlying cause analysis indicated any excess of diabetes, an outcome of a priori interest. Good candidates for multiple-cause analysis are diseases that are of long duration, not necessarily fatal, yet serious enough to be listed on the death certificate.

Cause of Death↗
PubMed2004

Prognosis in women with myocardial ischemia in the absence of obstructive coronary disease: results from the National Institutes of Health-National Heart, Lung, and Blood Institute-Sponsored Women's Ischemia Syndrome Evaluation (WISE).

BACKGROUND: We previously reported that 20% of women with chest pain but without obstructive coronary artery disease (CAD) had stress-induced reduction in myocardial phosphocreatine-adenosine triphosphate ratio by phosphorus-31 nuclear magnetic resonance spectroscopy (abnormal MRS), consistent with myocardial ischemia. The prognostic implications of these findings are unknown. METHODS AND RESULTS: Women referred for coronary angiography for suspected myocardial ischemia underwent MRS handgrip stress testing and follow-up evaluation. These included (1) n=60 with no CAD/normal MRS, (2) n=14 with no CAD/abnormal MRS, and (3) n=352 a reference group with CAD. Cardiovascular events were death, myocardial infarction, heart failure, stroke, other vascular events, and hospitalization for unstable angina. Cumulative freedom from events at 3 years was 87%, 57%, and 52% for women with no CAD/normal MRS, no CAD/abnormal MRS, and CAD, respectively (P<0.01). After adjusting for CAD and cardiac risk factors, a phosphocreatine-adenosine triphosphate ratio decrease of 1% increased the risk of a cardiovascular event by 4% (P=0.02). The higher event rate in women with no CAD/abnormal MRS was primarily due to hospitalization for unstable angina, which is associated with repeat catheterization and higher healthcare costs. CONCLUSIONS: Among women without CAD, abnormal MRS consistent with myocardial ischemia predicted cardiovascular outcome, notably higher rates of anginal hospitalization, repeat catheterization, and greater treatment costs. Further evaluation into the underlying pathophysiology and possible treatment options for women with evidence of myocardial ischemia but without CAD is indicated.

Adenosine Triphosphate↗