Acta Medica Port
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This study aimed to estimate the average intake of hematopoiesis related micronutrients and to assess the prevalence of anemia in elder female subjects aged 60 years or older residing in the outskirts of the Brazilian Federal District. ⋯ Our findings suggest that deficiency in vitamin B(12) intake constitutes a predisposing factor to the onset of anemia in the elderly.
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The objective of this manuscript is to discuss the existing barriers for the dissemination of medical guidelines, and to present strategies that facilitate the adaptation of the recommendations into clinical practice. The literature shows that it usually takes several years until new scientific evidence is adopted in current practice, even when there is obvious impact in patients' morbidity and mortality. There are some examples where more than thirty years have elapsed since the first case reports about the use of a effective therapy were published until its utilization became routine. ⋯ Therefore, these concepts could be very useful for institutions and services that aim at quality improvement of patient care. Changes in current medical practice recommended by guidelines may take some time. However, if there is a broader participation of opinion leaders and the use of several tools listed here, they surely have a greater probability of reaching the main objectives: improvement in provided medical care and patient safety.
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Comparative Study
[Efficiency versus quality in the NHS, in Portugal: methodologies for evaluation].
To proceed to the evaluation of the efficiency and quality in the NHS, based in methodologies of evaluation of management, indicators of benchmarking and indicators of process and outcome. The 1980 and 1990 decades have seen the proliferation of all forms of process indicators as a way to control health services. It is not a coincidence that the increase in managed care has been accompanied by an explosion of process indicators, as it has happened in the health system of the USA. ⋯ The outcome indicator number of episodes of inpatient care due to surgery infection in total days of inpatient care. Those indicators have been aggregated, by a mean. The Composite Indicator of Efficiency and Quality is the mean of the Composite Indicator of Efficiency and the Composite Indicator of Quality, having this one been converted in inverse base.
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Neurocognitive dysfunction is, nowadays, reported as one of the most frequent complications of cardiac surgery, with documented potential to have a negative impact on quality of life. Notwithstanding, the cognitive evaluation is almost exclusively restricted to research contexts, being depreciated in clinical settings. Cognitive functioning changes have mostly been investigated in patients submitted to coronary artery bypass grafting, with data reporting to valvular surgery still being extremely rare. ⋯ A notable variability between results of different studies may arise from diverse investigational methodologies and from factors related with difficulties inherent to the cognitive assessment, such as the diverse methods used for evaluation and the presence of a remarkable number of confounding factors. Investigation on valvular surgery neurocognitive effects is still in a very incipient period, being crucial to accurately establish the exact influence of the specific variables of this particular patient's group, such as the type of surgery and valve prosthesis. Furthermore, the clarification of the pathophysiological mechanisms subjacent to neurocognitive dysfunction might represent an important step to look for potential preventive or therapeutic strategies that could ameliorate brain function after cardiac surgery.
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Dental caries results from a complex interaction between the host and environmental factors and it is an important public health issue. ⋯ Dental caries was more prevalent in the six year old group with a male predominance. Children who brushed their teeth twice a day had less caries and the 12 year old group had more visits to the dentist. To ensure adequate oral hygiene habits it is important that parents supervise their children' habits.