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[PMID]:28463141
[Au] Autor:Pan HY; Mazur LM; Martin NE; Mayo CS; Santanam L; Pawlicki T; Marks LB; Smith BD
[Ad] Endereço:Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
[Ti] Título:Radiation Oncology Health Information Technology: Is It Working For or Against Us?
[So] Source:Int J Radiat Oncol Biol Phys;98(2):259-262, 2017 06 01.
[Is] ISSN:1879-355X
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Registros Eletrônicos de Saúde
Informática Médica
Radioterapia (Especialidade)
[Mh] Termos MeSH secundário: Boston
Congressos como Assunto
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE


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[PMID]:29377847
[Au] Autor:Maurer M; Canacari E; Eng K; Foley J; Phelan C; Sulmonte K; Wandel J
[Ad] Endereço:Author Affiliations: Senior Vice President for Patient Care Services and Chief Nursing Officer (Ms Maurer), Associate Chief Nurses (Mss Canacari, Foley, Phelan, and Sulmonte), and Program Director (Ms Wandel), Beth Israel Deaconess Medical Center, Boston; and Business Transformation Advisor (Ms Eng), Lynn Community Health Center, Lynn, Massachusetts.
[Ti] Título:Building a Culture of Continuous Improvement and Employee Engagement Using a Daily Management System Part 1: Overview.
[So] Source:J Nurs Adm;48(3):127-131, 2018 Mar.
[Is] ISSN:1539-0721
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:A daily management system (DMS) can be used to implement continuous quality improvement and advance employee engagement. It can empower staff to identify problems in the care environment that impact quality or workflow and to address them on a daily basis. Through DMS, improvement becomes the work of everyone, every day. The authors of this 2-part series describe their work to develop a DMS. Part 1 describes the background and organizing framework of the program.
[Mh] Termos MeSH primário: Cultura Organizacional
Administração de Recursos Humanos em Hospitais/normas
Melhoria de Qualidade/organização & administração
Engajamento no Trabalho
[Mh] Termos MeSH secundário: Centros Médicos Acadêmicos/organização & administração
Boston
Seres Humanos
Estudos de Casos Organizacionais
Administração de Recursos Humanos em Hospitais/métodos
Melhoria de Qualidade/normas
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:AIM; IM; N
[Da] Data de entrada para processamento:180130
[St] Status:MEDLINE
[do] DOI:10.1097/NNA.0000000000000593


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[PMID]:28993025
[Au] Autor:Cathey A; Ferguson KK; McElrath TF; Cantonwine DE; Pace G; Alshawabkeh A; Cordero JF; Meeker JD
[Ad] Endereço:Department of Environmental Health Sciences, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, USA.
[Ti] Título:Distribution and predictors of urinary polycyclic aromatic hydrocarbon metabolites in two pregnancy cohort studies.
[So] Source:Environ Pollut;232:556-562, 2018 Jan.
[Is] ISSN:1873-6424
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Pregnant women and their fetuses represent susceptible populations to environmental contaminants. Exposure to polycyclic aromatic hydrocarbons (PAHs) among pregnant women may contribute to adverse birth outcomes such as preterm birth. Multiple previous studies have assessed airborne sources of PAHs among pregnant women but few have measured urinary PAH metabolites which can capture total exposure through multiple routes. The aim of this study was to bridge this knowledge gap by assessing longitudinal urinary PAH metabolite concentrations over two time points in pregnancy cohorts in Boston (N = 200) and Puerto Rico (N = 50) to better understand exposure distributions throughout pregnancy and how they relate to demographic factors. Urine samples were analyzed for 1-NAP, 2-NAP, 2-FLU, 1-PHE, 2,3-PHE, 4-PHE, 9-PHE, and 1-PYR. Concentrations of 2-NAP, 1-PYR, and 4-PHE were higher in Puerto Rico, while all other metabolites were present in higher concentrations in Boston. In Puerto Rico, intraclass correlation coefficients (ICC) were weak to moderate, ranging from 0.06 to 0.42. PAH metabolite concentrations were significantly higher among younger, heavier (except 1-NAP and 9-PHE), and less educated individuals in Boston only. Consistent significant associations between PAH concentrations and measured covariates were not found in Puerto Rico. Our results suggest that potentially important differences in PAH exposure exist between these two populations. Additionally, our results indicate that multiple urinary measurements are required to accurately assess PAH exposure throughout pregnancy.
[Mh] Termos MeSH primário: Poluentes Ambientais/urina
Exposição Materna/estatística & dados numéricos
Hidrocarbonetos Aromáticos Policíclicos/urina
[Mh] Termos MeSH secundário: Adulto
Ácido Aspártico/análogos & derivados
Ácido Aspártico/urina
Biomarcadores/urina
Boston
Estudos de Coortes
Monitoramento Ambiental
Feminino
Seres Humanos
Naftalenossulfonatos/urina
Hidrocarbonetos Aromáticos Policíclicos/análise
Gravidez
Pirróis
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (1-nitro-2-acetylpyrrole); 0 (Biomarkers); 0 (Environmental Pollutants); 0 (Naphthalenesulfonates); 0 (Polycyclic Aromatic Hydrocarbons); 0 (Pyrroles); 141577-40-4 (N-(2-naphthalenesulfonyl)aspartyl-(2-phenethyl)amide); 30KYC7MIAI (Aspartic Acid)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180214
[Lr] Data última revisão:
180214
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171011
[St] Status:MEDLINE


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[PMID]:29292321
[Au] Autor:Simon L; Shroff D; Barrow J; Park SE
[Ad] Endereço:Dr. Simon is a Fellow in Oral Health and Medicine Integration, Harvard School of Dental Medicine and an MD student, Harvard Medical School; Deepti Shroff is a DMD student, Harvard School of Dental Medicine; Ms. Barrow is Associate Dean, Office of Global and Community Health, Harvard School of Dental
[Ti] Título:A Reflection Curriculum for Longitudinal Community-Based Clinical Experiences: Impact on Student Perceptions of the Safety Net.
[So] Source:J Dent Educ;82(1):12-19, 2018 Jan.
[Is] ISSN:1930-7837
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Community-based dental education (CBDE) allows dental students to be immersed in community settings and provide care to populations that are underserved. Exposure to those groups during training may impact provider attitudes, which may be strengthened by supporting students' reflection and exploration of their own attitudes. The aim of this study was to describe the implementation and preliminary results of a pilot longitudinal reflection curriculum integrated into a community-based clinical experience (CBCE) for senior dental students at one U.S. dental school and to report the impact of the reflection curriculum and CBCE on student experiences with populations that are underserved. In academic year 2015-16, all 35 senior dental students at one U.S. dental school were invited to complete an 11-item survey before and after completing a 12-week CBCE with integrated, longitudinal online reflections. Students received feedback from a faculty member after each reflection. All 35 students completed the survey, for a 100% response rate. After the CBCE, the students reported improved clinical efficiency and increased confidence in treatment planning and in treating dental emergencies and dentally anxious patients. They also reported improved understanding of the structure and relevance of community health centers, the role of different health care team members, and the impact of health policy. There was no significant difference in future plans to work with groups that are underserved. These results suggest that the CBCE and reflection curriculum had a positive impact on the students' clinical confidence as well as expanding their understanding of the broader oral health care delivery system. To address persistent oral health disparities, dental schools should continue to adopt CBDE programming that will prepare providers to effectively care for populations that are underserved.
[Mh] Termos MeSH primário: Atitude do Pessoal de Saúde
Odontologia Comunitária/educação
Serviços de Saúde Comunitária
Educação em Odontologia
Provedores de Redes de Segurança
Estudantes de Odontologia/psicologia
[Mh] Termos MeSH secundário: Boston
Currículo
Área Carente de Assistência Médica
Autorrelato
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180112
[Lr] Data última revisão:
180112
[Sb] Subgrupo de revista:D; IM
[Da] Data de entrada para processamento:180103
[St] Status:MEDLINE
[do] DOI:10.21815/JDE.018.004


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[PMID]:28452817
[Au] Autor:Manji F; McCarty K; Kurzweil V; Mark E; Rathmell JP; Agarwala AV
[Ad] Endereço:From the *Department of Anesthesia, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada; †Department of Medicine, Boston Medical Center, Boston, Massachusetts; ‡Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts; §Center for Quality and Safety, Massachusetts General Hospital, Boston, Massachusetts; ‖Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, Massachusetts; and ¶Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts.
[Ti] Título:Measuring and Improving the Quality of Preprocedural Assessments.
[So] Source:Anesth Analg;124(6):1846-1854, 2017 06.
[Is] ISSN:1526-7598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Preprocedural assessments are used by anesthesia providers to optimize perioperative care for patients undergoing invasive procedures. When these assessments are performed in advance by providers who are not caring for the patient during the procedure, there is an additional layer of complexity in ensuring that the workup meets the needs of the primary anesthesia care team. In this study, anesthesia providers were asked to rate the quality of preprocedural assessments prepared by other providers to evaluate anesthesia care team satisfaction. METHODS: Quality ratings for preprocedural assessments were collected from anesthesia providers on the day of surgery using an electronic quality assurance tool from January 9, 2014 to October 21, 2014. Users could rate assessments as "exemplary," "satisfactory," or "unsatisfactory." Free text comments could be entered for any of the quality ratings chosen. A reviewer trained in clinical anesthesia categorized all comments as "positive," "constructive," or "neutral" and conducted in-depth chart reviews triggered by 67 "constructive" comments submitted during the first 3 months of data collection to further subcategorize perceived deficiencies in the preprocedural assessments. In May 2014, providers were asked to participate in a midpoint survey and provide general feedback about the preprocedural process and evaluations. RESULTS: 37,611 procedures requiring anesthesia were analyzed. Of the 17,522 (46.6%) cases with a rated preprocedural assessment, anesthesia providers rated 3828 (21.8%) as "exemplary," 13,454 (76.8%) as "satisfactory," and 240 (1.4%) as "unsatisfactory." The monthly proportion of "unsatisfactory" ratings ranged from 3.1% to 0% over the study period, whereas the midpoint survey showed that anesthesia providers estimated that the number of unsatisfactory evaluations was 11.5%. Preprocedural evaluations performed on inpatients received significantly better ratings than evaluations performed on outpatients by the preadmission testing clinic or phone program (P < .0001). The most common reason given for "unsatisfactory" ratings was a perception of "missing information" (49.2%). Chart reviews revealed that inadequate documentation was in reality the most common deficiency in preprocedural evaluations (35 of 67 reviews, 52.2%). CONCLUSIONS: The overwhelming majority of preprocedural assessments performed at our institution were considered satisfactory or exemplary by day-of-surgery anesthesia providers. This was demonstrated by both the case-by-case ratings and midpoint survey. However, the perceived frequency of "unsatisfactory" evaluations was worse when providers were asked to reflect on the quality of preprocedural evaluations generally versus rate them individually. Analysis of comments left by providers allowed us to identify specific and actionable areas for improvement. This method can be used by other institutions to identify systemic deficiencies in the preprocedural evaluation process.
[Mh] Termos MeSH primário: Anestesiologistas/normas
Equipe de Assistência ao Paciente/normas
Cuidados Pré-Operatórios/normas
Melhoria de Qualidade/normas
Indicadores de Qualidade em Assistência à Saúde/normas
[Mh] Termos MeSH secundário: Serviço Hospitalar de Anestesia
Anestesiologistas/psicologia
Atitude do Pessoal de Saúde
Boston
Competência Clínica
Conhecimentos, Atitudes e Prática em Saúde
Hospitais Gerais
Seres Humanos
Pacientes Internados
Ambulatório Hospitalar
Pacientes Ambulatoriais
Avaliação de Programas e Projetos de Saúde
Análise e Desempenho de Tarefas
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:180109
[Lr] Data última revisão:
180109
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1213/ANE.0000000000001834


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[PMID]:29172348
[Au] Autor:Klaff A; Wilson J; Cain J
[Ti] Título:Dangerous Blasts. Preparing for explosive incident responses.
[So] Source:JEMS;41(8):57-61, 2016 08.
[Is] ISSN:0197-2510
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Traumatismos por Explosões/terapia
Bombas (Dispositivos Explosivos)
Planejamento em Desastres
Serviços Médicos de Emergência/organização & administração
Explosões
Incidentes com Feridos em Massa
Terrorismo
[Mh] Termos MeSH secundário: Boston
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171214
[Lr] Data última revisão:
171214
[Sb] Subgrupo de revista:H
[Da] Data de entrada para processamento:171128
[St] Status:MEDLINE


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[PMID]:29206986
[Au] Autor:Wilson A; Chiu YM; Hsu HL; Wright RO; Wright RJ; Coull BA
[Ti] Título:Potential for Bias When Estimating Critical Windows for Air Pollution in Children's Health.
[So] Source:Am J Epidemiol;186(11):1281-1289, 2017 Dec 01.
[Is] ISSN:1476-6256
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Evidence supports an association between maternal exposure to air pollution during pregnancy and children's health outcomes. Recent interest has focused on identifying critical windows of vulnerability. An analysis based on a distributed lag model (DLM) can yield estimates of a critical window that are different from those from an analysis that regresses the outcome on each of the 3 trimester-average exposures (TAEs). Using a simulation study, we assessed bias in estimates of critical windows obtained using 3 regression approaches: 1) 3 separate models to estimate the association with each of the 3 TAEs; 2) a single model to jointly estimate the association between the outcome and all 3 TAEs; and 3) a DLM. We used weekly fine-particulate-matter exposure data for 238 births in a birth cohort in and around Boston, Massachusetts, and a simulated outcome and time-varying exposure effect. Estimates using separate models for each TAE were biased and identified incorrect windows. This bias arose from seasonal trends in particulate matter that induced correlation between TAEs. Including all TAEs in a single model reduced bias. DLM produced unbiased estimates and added flexibility to identify windows. Analysis of body mass index z score and fat mass in the same cohort highlighted inconsistent estimates from the 3 methods.
[Mh] Termos MeSH primário: Poluição do Ar/efeitos adversos
Saúde do Lactente
Exposição Materna/efeitos adversos
Material Particulado/efeitos adversos
Resultado da Gravidez/epidemiologia
[Mh] Termos MeSH secundário: Viés
Boston/epidemiologia
Simulação por Computador
Fatores de Confusão (Epidemiologia)
Feminino
Seres Humanos
Lactente
Modelos Lineares
Masculino
Gravidez
Trimestres da Gravidez
Estações do Ano
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Particulate Matter)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171213
[Lr] Data última revisão:
171213
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171206
[St] Status:MEDLINE
[do] DOI:10.1093/aje/kwx184


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[PMID]:29173303
[Au] Autor:Beinvogl B; Sabharwal S; McSweeney M; Nurko S
[Ad] Endereço:Center for Motility and Functional Gastrointestinal Disorders, Boston Children's Hospital, Boston, MA; Division of Pediatric Gastroenterology, Boston Children's Hospital, Boston, MA.
[Ti] Título:Are We Using Abdominal Radiographs Appropriately in the Management of Pediatric Constipation?
[So] Source:J Pediatr;191:179-183, 2017 Dec.
[Is] ISSN:1097-6833
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To identify the reasons why pediatric gastroenterologists obtain abdominal radiographs in the management of pediatric constipation. STUDY DESIGN: This was a prospective study surveying providers regarding their rationale, interpretation, resultant change, and confidence in their management before and after obtaining KUBs in patients seen for suspected constipation. Demographics and clinical findings were obtained from medical records. RESULTS: A total of 24 providers were surveyed after 72 patient encounters. Reasons for obtaining an abdominal radiograph included evaluation of stool burden (70%), need for a clean out (35%), fecal impaction (27%), cause of abdominal pain (24%), demonstration of stool burden to families (14%), assessment of response to therapy (13%), or encopresis (10%). The plan was changed in 47.6% of cases based on radiographic findings. In cases in which a plan was outlined before obtaining the radiograph (69%), the initial plan was implemented on average in 52.5%. In cases with no plans before obtaining the radiograph, previously unconsidered plans were implemented in 8.7%. Provider confidence in the management plan increased from 2.4 ± 2.7 to 4.1 ± 1.8 (P < .05) after the abdominal radiograph. CONCLUSION: Abdominal radiographs commonly are obtained by pediatric gastroenterologists in the evaluation and management of constipation. The majority used it to make a diagnosis, and nearly one-half changed their management based on the imaging findings. Overall, they reported an improved confidence in their management plan, despite evidence that radiographic findings poorly correlate with clinical severity. This study highlights the need for further provider education regarding the recommendations delineated in existing constipation guidelines.
[Mh] Termos MeSH primário: Tomada de Decisão Clínica/métodos
Constipação Intestinal/diagnóstico por imagem
Gastroenterologia
Fidelidade a Diretrizes/estatística & dados numéricos
Pediatria
Padrões de Prática Médica/estatística & dados numéricos
[Mh] Termos MeSH secundário: Dor Abdominal/diagnóstico por imagem
Dor Abdominal/etiologia
Adolescente
Boston
Criança
Pré-Escolar
Competência Clínica
Constipação Intestinal/etiologia
Constipação Intestinal/terapia
Feminino
Pesquisas sobre Serviços de Saúde
Seres Humanos
Masculino
Guias de Prática Clínica como Assunto
Estudos Prospectivos
Radiografia Abdominal
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171211
[Lr] Data última revisão:
171211
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171128
[St] Status:MEDLINE


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[PMID]:28741408
[Au] Autor:Hughes AL; Roberson D; Bannos C; Trudell EK; Vernacchio L
[Ad] Endereço:1 Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, Massachusetts, USA.
[Ti] Título:Appropriateness of Tympanostomy Tubes in the Boston Metropolitan Area: Are the AAO-HNSF Guidelines Being Met?
[So] Source:Otolaryngol Head Neck Surg;157(6):1041-1047, 2017 Dec.
[Is] ISSN:1097-6817
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Introduction Otitis media (OM) is the most common reason children receive general anesthesia, with bilateral tympanostomy tube (TT) insertion the second most common surgery in children. Prior research suggests overuse of TT. As part of a project designed to improve appropriateness of OM referrals, we evaluated appropriateness of TT insertion in a patient cohort. Methods Patients younger than 9 years with initial otolaryngology (ORL) visits in academic and private office settings for OM from January 1, 2012, to August 31, 2013, were identified through claims database. A detailed retrospective chart review of patients undergoing TT insertion was performed to determine appropriateness of TT insertion per the 2013 American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF) guidelines. Results A total of 120 patients undergoing TT insertion were randomly chosen for detailed chart review; 32 patients were excluded. Sixty-six (75%) of 88 patients available for analysis met AAO-HNSF guidelines for TT. Recurrent acute OM with middle ear effusion was the most common indication (56%). Other indications included chronic OME and TT in at-risk patients with speech, learning, or behavioral delays. Of the 22 patients undergoing TT insertion not meeting AAO-HNSF guidelines, 11(50%) had abnormal exams, but were 1 to 2 infections short of meeting guidelines; 7 (33%) had normal exams but met criteria for number of infections. Discussion Contrary to prior publications, 75% of patients undergoing TT insertion had an appropriate indication per AAO-HNSF guidelines. In only 5% was TT insertion a substantial departure from guidelines. Implications for Practice The study outcomes suggest appropriate clinical decision making, improved guideline adherence, and better guideline applicability from the previously published 1994 and 2004 guidelines.
[Mh] Termos MeSH primário: Fidelidade a Diretrizes
Ventilação da Orelha Média/normas
Otite Média/cirurgia
[Mh] Termos MeSH secundário: Boston
Criança
Pré-Escolar
Doença Crônica
Feminino
Seres Humanos
Lactente
Masculino
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171211
[Lr] Data última revisão:
171211
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170726
[St] Status:MEDLINE
[do] DOI:10.1177/0194599817721454


  10 / 7948 MEDLINE  
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[PMID]:29048959
[Au] Autor:Brooks CJ; Barrett J; Daly J; Lee R; Blanding N; McHugh A; Williams D; Gortmaker S
[Ad] Endereço:Carolyn J. Brooks, Jessica Barrett, James Daly, Rebekka Lee, David Williams, and Steven Gortmaker are with the Harvard T. H. Chan School of Public Health, Boston, MA. Nineequa Blanding and Anne McHugh are with the Boston Public Health Commission, Boston.
[Ti] Título:A Community-Level Sodium Reduction Intervention, Boston, 2013-2015.
[So] Source:Am J Public Health;107(12):1951-1957, 2017 Dec.
[Is] ISSN:1541-0048
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: To evaluate a community-level sodium-reduction intervention in Boston, Massachusetts. Reducing sodium in the food offerings of community settings may help reduce hypertension disparities. METHODS: We examined changes in the proportion of prepackaged foods with greater than 200 milligrams of sodium in 7 hospitals, 8 YMCAs, 4 community health centers, and 2 organizations serving homeless populations. Research assistants documented prepackaged items in cafeterias, kiosks, and vending machines before and after the intervention (2013-2015). We assessed intervention change via linear mixed models accounting for repeated observations. RESULTS: There were 161 access points at baseline (4347 facings) and 171 (4996 facings) at follow-up. The percentage of prepackaged products with greater than 200 milligrams of sodium decreased from 29.0% at baseline to 21.5% at follow-up (P = .003). Changes were driven by improvements in hospital cafeterias and kiosks (P = .003). The percentage of products with greater than 200 milligrams of sodium in YMCA vending decreased 58% (from 27.2% to 11.5%; P = .017); other organizations had nonsignificant declines. CONCLUSIONS: We found modest reductions in the percentage of higher-sodium prepackaged products across community institutions. Community-level interventions may increase availability of lower-sodium products in the food supply.
[Mh] Termos MeSH primário: Centros Comunitários de Saúde
Alimentos/normas
Promoção da Saúde/métodos
Hospitais
Sódio na Dieta
[Mh] Termos MeSH secundário: Boston
Distribuidores Automáticos de Alimentos
Serviço Hospitalar de Nutrição
Seres Humanos
Hipertensão/prevenção & controle
Lanches
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Sodium, Dietary)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171113
[Lr] Data última revisão:
171113
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171020
[St] Status:MEDLINE
[do] DOI:10.2105/AJPH.2017.304070



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