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The organization of public clinical laboratories is experiencing changes without, however, an organizational assessment of its effectiveness. The study aimed to determine a parameter of effectiveness for public clinical laboratories of Belo Horizonte, Minas Gerais State, and set cut-off points for the sections of these laboratories. In order to do so, the total production and number of hours worked during a period of 7 months in the year 2008 were consolidated. Due to the entrance of the workers in the mode of production in the laboratories network, it could be observed a variability regarding the performance of these workers. The effectiveness parameter of the network was established in 29.90 tests per hour. As a consequence of this first analysis, the cut-off points are: 15.50 for the hematology section; 67.29 for chemestry; 6.45 for parasitology; 11.35 for urinalysis; 4.94 for microbiology and 19.03 for immunology. From these results, it was concluded that the working process in laboratories can generate a decrease in effectiveness. Source

Patel M.M.,Centers for Disease Control and Prevention | Lopez-Collada V.R.,National Center for Child and Adolescent Health | Bulhoes M.M.,Centers for Disease Control and Prevention | De Oliveira L.H.,Pan American Health Organization | And 32 more authors.
New England Journal of Medicine

Background: Because postlicensure surveillance determined that a previous rotavirus vaccine, RotaShield, caused intussusception in 1 of every 10,000 recipients, we assessed the association of the new monovalent rotavirus vaccine (RV1) with intussusception after routine immunization of infants in Mexico and Brazil. Methods: We used case-series and case-control methods to assess the association between RV1 and intussusception. Infants with intussusception were identified through active surveillance at 69 hospitals (16 in Mexico and 53 in Brazil), and age-matched infants from the same neighborhood were enrolled as controls. Vaccination dates were verified by a review of vaccination cards or clinic records. Results: We enrolled 615 case patients (285 in Mexico and 330 in Brazil) and 2050 controls. An increased risk of intussusception 1 to 7 days after the first dose of RV1 was identified among infants in Mexico with the use of both the case-series method (incidence ratio, 5.3; 95% confidence interval [CI], 3.0 to 9.3) and the case-control method (odds ratio, 5.8; 95% CI, 2.6 to 13.0). No significant risk was found after the first dose among infants in Brazil, but an increased risk, albeit smaller than that seen after the first dose in Mexico - an increase by a factor of 1.9 to 2.6 - was seen 1 to 7 days after the second dose. A combined annual excess of 96 cases of intussusception in Mexico (approximately 1 per 51,000 infants) and in Brazil (approximately 1 per 68,000 infants) and of 5 deaths due to intussusception was attributable to RV1. However, RV1 prevented approximately 80,000 hospitalizations and 1300 deaths from diarrhea each year in these two countries. Conclusions: RV1 was associated with a short-term risk of intussusception in approximately 1 of every 51,000 to 68,000 vaccinated infants. The absolute number of deaths and hospitalizations averted because of vaccination far exceeded the number of intussusception cases that may have been associated with vaccination. (Funded in part by the GAVI Alliance and the U.S. Department of Health and Human Services.) Copyright © 2011 Massachusetts Medical Society. Source

Soares I.C.C.,Nutricionista | da Silva E.R.,Secretaria de Estado da Saude de Minas Gerais | Priore S.E.,Secretaria de Estado da Saude de Minas Gerais | Ribeiro R.C.L.,Secretaria de Estado da Saude de Minas Gerais | And 2 more authors.
Revista de Nutricao

Objective The purpose of this study was to quantify and assess the cost of food wastage in eight cafeterias of a big steel mill. Methods Eight cafeterias were followed during five months. Quantification of food wastage was done considering the leftovers and the number of meals planned and served daily. For determining the cost, preparations were divided into groups, and the cost was obtained from the average price of foodstuffs purchased during the month. Results Fifty percent of the cafeterias did not achieve wastage less or equal to 30g (the per capita food wastage goal set by the company). The total per capita food wastage ranged from 24g to 60g, equivalent to 176-1213kg of food wasted monthly. Salads were wasted more often in most foodservices. The monthly cost of food wastage reached 2.2% to 3.0% of the amount spent monthly on food. It represented a high expense for the foodservice (approximately 80-108 minimum wages). The results allowed the proposal of intervention measures such as planning and development of appropriate preparations, identification of customers, and nutrition education actions. Conclusion The cafeterias presented considerable food wastage, hence money loss. Implementation of interventions can minimize these losses. Savings from reducing wasteful spending could be used for improving production processes. Source

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