Unidad De Research Articles

Suicidal ideation among prisoners: analysis with a gender perspective in a five-year follow-up (2017-2022).

There is a high incidence of self-harming behavior in the prison setting, with a suicide rate that is higher than that of the general population. Previous studies describe the association of sociodemographic, clinical, and criminological factors with the risk of suicide in the male prison population, but there is little research that specifically analyses suicidal behavior among women. The objective of this study is to analyze the characteristics of inmates who are admitted to a psychiatric unit for suicidal thoughts or attempted suicide. Descriptive and comparative analysis of 97 inmates (68 men, 29 women) admitted to the Unidad de Hospitalización Psiquiátrica Penitenciaria de Cataluña (UHPP-C), for suicidal ideation, between January 1, 2017, and December 31, 2022. There are differences in terms of place of birth, with a more significant presence of African nationalities in non-national males, while foreign inmates tend to come from Latin American countries. Men have a lower mean age, longer admissions, and a higher readmission rate. They also suffer from more psychotic and addictive disorders. Women have a higher prevalence of personality disorders and affective symptoms. There are sociodemographic and clinical differences between male and female prison inmates who require admission for suicidal ideation. Including a gender perspective in studies on suicide risk in the prison population can provide a solid foundation for future studies, thus allowing a more complete understanding of suicidal ideation and intervention needs in the prison population.

Psychosocial risks and their consequences on health and job satisfaction among Spanish police officers.

Police officers are exposed to risk and violence, which makes their work highly stressful. According to the Job Demand-Resource model, the working conditions of police officers may affect their health and job satisfaction. The aims of this research were to evaluate the psychosocial factors at work in a sample of municipal police officers from the Valencian Community (Spain) to identify the prevalence of psychosocial risks and their consequences and analyse the influence of psychosocial factors (resource and demands) at work on job satisfaction and health. The Unidad de Investigación Psicosocial de la Conducta Organizacional (UNIPSICO) battery was used to evaluate the prevalence and distribution of different levels of risk and their consequences in police officers (n=103). The influence of psychosocial factors (resource and demands) at work on psychosomatic disorders and job satisfaction was examined using stepwise regression analysis. All considered variables showed moderate levels of psychosocial risk for the whole sample. As for the consequences of psychosocial risks, moderate levels of psychosomatic disorders and job satisfaction were also observed. Perceived stress levels and organizational stressors have a negative effect on health and job satisfaction. To create positive conditions for the health and well-being of police officers, real commitment is required when evaluating psychosocial risks in local police organizations and the establishment of prevention and intervention measures where psychosocial risk factors are detected.

Psychometric properties of the digital competences scale in regular basic education teachers

Since the introduction of technology in the classroom, there has been a growing demand for digital competencies, which has driven the need for validated instruments to assess this concept more prominently. Therefore, this study determined the psychometric properties of a self-assessment scale of digital competencies for teachers of Regular Basic Education. The study was carried out in the Unidad de Gestión Educativa Local (UGEL)/District Education Management Unit of Barranca and Huaura located north of Lima, Peru. A cross-sectional and instrumental quantitative methodological strategy was used, in which exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) techniques were used, and 534 teachers were surveyed. The results show an EFA with two factors and loadings greater than 0.4, a KMO equal to 0.957, and a cumulative variance of 51.30%. The CFA analysis validated three models, where model 2 with three factors, Evaluación y Promoción (EP)/Evaluation and Promotion; Recursos Digitales en la Enseñanza (RDE)/Digital Resources in Teaching; and Participación Profesional en el Aprendizaje (PPA)/Professional Participation in Learning, yielded high correlations and adequate goodness-of-fit indices close to unity (X2/df =1.476; RMSEA=0.042; TLI=0.97; and CFI=0.97). It can be observed that model 2, which includes three factors, presents more appropriate measures, which makes it the most suitable option for assessing digital competencies in teachers of Regular Basic Education.

Evaluation of the Scientific Production in the Field of General Practice and Family Medicine in Portugal

The Portuguese publications in the field of General Practice and Family Medicine have not yet been assessed in bibliometric studies. The aim of this study was to analyze that production between 2012 and 2022. The Web of Science Core Collection was used to gather the number of articles, journals and citations obtained; the Journal Citation Reports to obtain the Impact Factor and quartile of journals; and Scimago Journal & Country Rank, for the comparison of data with other European countries. The search was based on the following query: "usf OR unidade de Saude Familiar OR centro de Saude OR ACeS OR medicina geral familiar OR Gen Practice Family SAME Portugal", and a time window between 2012 and 2022 was defined. The study considered the following quantitative indicators: total number of publications, typology, language, affiliation, co-authors, geographical distribution, thematic areas, and the number of publications/inhabitant and publications/physician from European countries; the qualitative indicators selected were the Impact Factor (IF), the quartile and the number of citations. Between 2012 and 2022, the national scientific production had an average annual growth rate of 36.6%. Of 389 publications, 73.8% were 'Articles' and 11.8% were 'Review Articles', predominantly in English (88.4%). The fields of 'General Internal Medicine' (24.7%) and 'Public Environmental Health' (14.9%) had the highest publication rates among the journals. The 389 publications received 5354 citations, for an average of 13.76 citations per article, and the average yearly citation growth was 115%. According to IF, 22.5% of the 222 journals belonged to Q4, 27.5% to Q3, 29.7% to Q2 and 20.3% to Q1, and therefore no significant bias regarding the journals where Portuguese doctors publish was observed. The bibliometric analysis allowed us to examine the evolution of the scientific production in the field of Portuguese General Practice and Family Medicine by observing an increasing publication trend and with a high potential for publication growth.

Improving User Experience: Designing an Intuitive and Visually Appealing Interface for University First Contact and Ombudsman Services for the Centro Universitario del Sur

In an unprecedented effort to comprehensively address the issues of gender violence, harassment, and bullying, the University of Guadalajara has implemented a support structure that involves the University Rights Ombudsman (DDU, Defensoria de los Derechos Universitarios, acronym in Spanish), the Unit for Equality (UI, Unidad de Igualdad, acronym in Spanish), and the First Contact offices (PC, Primeros Contactos, acronym in Spanish). Furthermore, The University of Guadalajara has established the Protocol for the Prevention, Attention, Sanction, and Eradication of gender violence (PPASE, Protocolo para la Prevención, Atención, Sansión y Erradicación de la Violencia de Género, acronym in Spanish) [1]. The University of Guadalajara has a network of university campuses throughout the state of Jalisco in Mexico. The Centro Universitario del Sur is one of these campuses, commonly referred to as CUSur. Despite these significant advancements in the implementation of the PPASE, the university community at CUSur generally faces challenges in understanding the processes, situations, and characteristics of these entities and regulations, placing victims or potential victims in a vulnerable situation. It is essential to expedite the information and attention processes for potential victims, and in this regard, technology can play a pivotal role. We are developing a technological intervention strategy to facilitate access for the university community, especially for victims who need to utilize the resources offered by the University of Guadalajara. To achieve this goal, we research user experience and identify the current usability of the webpage, focusing on understanding specific needs and challenges. The goal is to design an intuitive and appealing user interface that provides clear and accessible information about the available processes, services, and resources. Leveraging best practices in Human-Computer Interaction (HCI) is expected to enhance the visualization of the attention processes and foster trust in the entities responsible for providing support.

Sampling frequency optimization of the water quality monitoring network in São Paulo State (Brazil) towards adaptive monitoring in a developing country.

Water quality monitoring networks (WQMNs) that capture both the temporal and spatial dimensions are essential to provide reliable data for assessing water quality trends in surface waters, as well as for supporting initiatives to control anthropogenic activities. Meeting these monitoring goals as efficiently as possible is crucial, especially in developing countries where the financial resources are limited and the water quality degradation is accelerating. Here, we asked if sampling frequency could be reduced while maintaining the same degree of information as with bimonthly sampling in the São Paulo State (Brazil) WQMN. For this purpose, we considered data from 2004 to 2018 for 56 monitoring sites distributed into four out of 22 of the state's water resources management units (UGRHIs, "Unidades de Gerenciamento de Recursos Hídricos"). We ran statistical tests for identifying data redundancy among two-month periods in the dry and wet seasons, followed by objective criteria to develop a sampling frequency recommendation. Our results showed that the reduction would be feasible in three UGRHIs, with the number of annual samplings ranging from two to four (instead of the original six). In both seasons, dissolved oxygen and Escherichia coli required more frequent sampling than the other analyzed parameters to adequately capture variability. The recommendation was compatible with flexible monitoring strategies observed in well-structured WQMNs worldwide, since the suggested sampling frequencies were not the same for all UGRHIs. Our approach can contribute to establishing a methodology to reevaluate WQMNs, potentially resulting in less costly and more adaptive strategies in São Paulo State and other developing areas with similar challenges.

Condições de trabalho na atenção primária à saúde na pandemia de COVID-19: um panorama sobre Brasil e Portugal

Abstract The COVID-19 pandemic has put pressure on public health systems worldwide since 2020. This article aims to discuss working conditions in Primary Health Care (PHC) in Brazil, while dialoguing with primary health care (CSP, Cuidados de Saúde Primários) in Portugal in the pandemic scenario. For that purpose, data from the study “Working conditions of health professionals in the context of COVID-19 in Brazil” are presented, for further discussion with the report produced by “Family Health Units - National Association (USF-AN, Unidades de Saúde Familiar - Associação Nacional)” on the CSP in Portugal. In Brazil, regarding the sample of 3,895 PHC health professionals, it was observed: multiple employment relationships, lack of institutional support and specific training, living with fake news and the lack of political cohesion between health authorities, with significant changes in these workers’ mental health. In Portugal, the increase in the workload and the presence of Burnout Syndrome among FHU professionals was emphasized. The pandemic had a significant impact on the health and daily work of health professionals in PHC and CSP. However, the Brazilian context was more adverse due to fake news and divergences regarding conducts related to the fight against the pandemic, due to the actions and denialism by the federal government.

Working conditions in primary health care in the COVID-19 pandemic: an overview of Brazil and Portugal.

The COVID-19 pandemic has put pressure on public health systems worldwide since 2020. This article aims to discuss working conditions in Primary Health Care (PHC) in Brazil, while dialoguing with primary health care (CSP, Cuidados de Saúde Primários) in Portugal in the pandemic scenario. For that purpose, data from the study "Working conditions of health professionals in the context of COVID-19 in Brazil" are presented, for further discussion with the report produced by "Family Health Units - National Association (USF-AN, Unidades de Saúde Familiar - Associação Nacional)" on the CSP in Portugal. In Brazil, regarding the sample of 3,895 PHC health professionals, it was observed: multiple employment relationships, lack of institutional support and specific training, living with fake news and the lack of political cohesion between health authorities, with significant changes in these workers' mental health. In Portugal, the increase in the workload and the presence of Burnout Syndrome among FHU professionals was emphasized. The pandemic had a significant impact on the health and daily work of health professionals in PHC and CSP. However, the Brazilian context was more adverse due to fake news and divergences regarding conducts related to the fight against the pandemic, due to the actions and denialism by the federal government.

Análisis de las características de los pacientes mayores que ingresaron en una unidad de cuidados intensivos durante las 6 olas de la pandemia por SARS-CoV-2: implicaciones para la atención médica

ObjectiveTo analyze the characteristics of seriously ill elderly patients during the six waves of the COVID-19 pandemic. MethodRetrospective, observational and analytical study of patients over 70 years of age admitted to the ICU (March-2020 to March-2022). Patients were categorized into three groups based on age: 70-74 years; 75-79 years; and >80 years. A descriptive and comparative analysis of the sample was initially performed; and a 28-, 60- and 90-day survival analysis using the Kaplan–Meier method. Multivariate survival analysis was performed by fitting a Cox model. ResultsOf 301 patients, the lowest number of admissions occurred during the first wave (20 (6%)), compared to the wave with the highest number of admissions: the sixth wave (76 (25%)). The survival curves at 28 days, 60 days and 90 days showed a higher probability of survival in the younger age groups (P<.01 and P=.01, respectively). Troponin at admission (per unit, ng/l) showed a significant association with 28- and 60-day mortality (HR: 1.00; 95% CI: 1.00-1.01; P<.05). Taking the 1st wave of the pandemic as a reference, admission in the 3rd wave behaved as a protective factor against mortality at 28 and 60 days of follow-up (HR: 0.18; 95% CI: 0.02-0.64; P<.05; HR: 0.13; 95% CI: 0.02–0.64; P<.05, respectively). ConclusionsThe time of admission and biomarkers, such as troponin, constitute prognostic markers independent of age in the elderly population.

PREVALENCE OF STOMATOLOGICAL ALTERATIONS IN PREGNANT WOMEN FROM THE CITY OF CURITIBA, BRAZIL

Objective Determine the prevalence of diseases or alterations in oral soft tissues of pregnant women attended to care at the "Unidade de Saúde Mãe Curitibana", Curitiba, Brazil. Study Design A cross-sectional and observational study, linked to the "Coorte de Saúde Materno-Infantil de Curitiba (COOSMIC)", whose sample consisted of 187 pregnant women, mean age 25.28 years (± 6.63). All pregnant women were interviewed with a questionnaire, regardless of any prenatal period, followed by extraoral and intraoral examinations, using ambient light, mouth mirrors, periodontal probes, and wooden spatulas. Results The results were analyzed descriptively. From the 187 pregnant women, 152 (81.28%) presented no stomatological alterations. Thirty-five (8.71%) pregnant women presented the following isolated oral alterations: fissured tongue (31.42%), benign migratory glossitis (22.85%), depapillated tongue (2.85%), herpes simplex (2.85%), and pyogenic granuloma (2.85%). Three pregnant women had more than one alteration: benign migratory glossitis and fissured tongue (2.85%), ankyloglossia and depapillated tongue (2.85%), and ankyloglossia and fissured tongue (2.85%). Other different conditions from those above mentioned were present in 10 (28.57%) cases. Conclusion The most prevalent conditions in pregnant women was fissured tongue (N=11; 31.42%), and benign migratory glossitis (N=8; 22.85%). Dental care of pregnant women is essential for their oral health maintenance. Determine the prevalence of diseases or alterations in oral soft tissues of pregnant women attended to care at the "Unidade de Saúde Mãe Curitibana", Curitiba, Brazil. A cross-sectional and observational study, linked to the "Coorte de Saúde Materno-Infantil de Curitiba (COOSMIC)", whose sample consisted of 187 pregnant women, mean age 25.28 years (± 6.63). All pregnant women were interviewed with a questionnaire, regardless of any prenatal period, followed by extraoral and intraoral examinations, using ambient light, mouth mirrors, periodontal probes, and wooden spatulas. The results were analyzed descriptively. From the 187 pregnant women, 152 (81.28%) presented no stomatological alterations. Thirty-five (8.71%) pregnant women presented the following isolated oral alterations: fissured tongue (31.42%), benign migratory glossitis (22.85%), depapillated tongue (2.85%), herpes simplex (2.85%), and pyogenic granuloma (2.85%). Three pregnant women had more than one alteration: benign migratory glossitis and fissured tongue (2.85%), ankyloglossia and depapillated tongue (2.85%), and ankyloglossia and fissured tongue (2.85%). Other different conditions from those above mentioned were present in 10 (28.57%) cases. The most prevalent conditions in pregnant women was fissured tongue (N=11; 31.42%), and benign migratory glossitis (N=8; 22.85%). Dental care of pregnant women is essential for their oral health maintenance.

Psychological Well-being and the relationship with Nursing Competence in an Intensive Care Unit

Objective: To determine the relationship between the psychological Bienestar (BP) and the nursing competence of nursing staff in a Unidad de Cidados Intensivos (ICU). Methodology: Quantitative, relational, cross-sectional and prospective, a census was conducted among 31 ICU nurses at the ISSSTE (Institute of Security and Social Services of State Workers), Aguascalientes. Carol Ryff’s “Psychological Well-Being Scale" and Ritta Meretoja's "Nursing Competence Scale" were used. Results: 67.7% of nurses working in the ICU have a high level of BP, and 83.9% have a very good level of nursing competence. Through a correlation test by Rho Spearman, he obtained that there is no relationship between the level of nursing competence of those who work in the ICU with their level of BP. Conclusion: There is not enough statistical evidence to say that there is a relationship between nursing competence and BP. The BP does not affect nursing competence, despite being a service of high demand for care and adequate attention and care is provided to the critical patient.

Comportamiento de la infección SARSCoV-2 (COVID-19) en pacientes con diabetes mellitus tipo 2 en una unidad de cuidados respiratorios

Comportamiento de la infección SARSCoV-2 (COVID-19) en pacientes con diabetes mellitus tipo 2 en una unidad de cuidados respiratorios

Prevalence of lung cancer in Colombia and a new diagnostic algorithm using health administrative databases: A real-world evidence study.

Reliable, timely and detailed information on lung cancer prevalence, mortality and costs from middle-income countries is essential to policy design. Thus, we aimed to develop an electronic algorithm to identify lung cancer prevalent patients in Colombia by using administrative claims databases, as well as to estimate prevalence rates by age, sex and geographic region. We performed a cross-sectional study based on national claim databases in Colombia (Base de datos de suficiencia de la Unidad de Pago por Capitación and Base de Datos Única de Afiliados) to identify lung cancer prevalent patients in 2017, 2018 and 2019. Several algorithms based on the presence or absence of oncological procedures (chemotherapy, radiotherapy and surgery) and a minimum number of months that each individual had lung cancer ICD-10 codes were developed. After testing 16 algorithms, those with the closest prevalence rates to those rates reported by aggregated official sources (Global Cancer Observatory and Cuenta de Alto Costo) were selected. We estimated prevalence rates by age, sex and geographic region. Two algorithms were selected: i) one algorithm that was defined as the presence of ICD-10 codes for 4 months or more (the sensitive algorithm); and ii) one algorithm that was defined by adding the presence of at least one oncological procedure (the specific algorithm). The estimated prevalence rates per 100,000 inhabitants ranged between 11.14 and 18.05 for both, the contributory and subsidized regimes over years 2017, 2018 and 2019. These rates in the contributory regime were higher in women (15.43, 15.61 and 17.03 per 100,000 for years 2017, 2018 and 2019), over 65-years-old (63.45, 56.92 and 61.79 per 100,000 for years 2017, 2018 and 2019) who lived in Central, Bogota and Pacific regions. Selected algorithms showed similar aggregated prevalence estimations to those rates reported by official sources and allowed us to estimate prevalence rates in specific aging, regional and gender groups for Colombia by using national claims databases. These findings could be useful to identify clinical and economical outcomes related to lung cancer patients by using national individual-level databases.

Occurrence and distribution of the heterotrophic straminipiles from Brazilian Atlantic Rainforest areas

ABSTRACT We present herein the occurrence and distribution of the heterotrophic straminipiles collected from soil and water, submerged leaves and surface sediment from freshwater bodies at “Mosaico de Unidades de Conservação Juréia-Itatins”, a preserved conservation unit of the Brazilian Atlantic Rainforest. From 180 collected samples, we isolated 41 taxa belonging to Hyphochytriomycota and Oomycota using the multiple baiting technique, with several new taxa to the science, new occurrences to São Paulo State or Brazil, and all new citation to the studied area. These taxa were identified based on morphological and/or molecular data, with several genic regions made available in GenBank. The calculated community structure of these zoosporic organisms showed a diverse community, with few dominant taxa, without significant differences (P≤0.05) among the different types of samples.

Injúria renal aguda com terapia renal substitutiva na Unidade de Terapia Intensiva Pediátrica do Hospital Infantil Dr. Jeser Amarante Faria

INTRODUCTION: Acute kidney injury (AKI) is defined as a sudden reduction in kidney function, which ranges from mild changes in kidney biomarkers to severe conditions that require renal replacement therapy (RRT). RRT is the most effective treatment for patients with severe AKI, and the most used RRT methods are: conventional hemodialysis (HD), continuous hemodialysis and peritoneal dialysis (PD). OBJECTIVES: This study aims to analyze the epidemiological profile and outcome of patients diagnosed with Acute Kidney Injury undergoing renal replacement therapy in the Intensive Care Unit. METHODS: For this, a descriptive, observational, cross-sectional study was carried out through the retrospective collection of data obtained through the electronic medical record system. RESULTS: Among the hospitalizations during the study period, 3.67% required RRT due to AKI, with sepsis as the main cause (48.57%). Most patients underwent RRT through HD. The mortality rate was 45.7%, showing higher mortality in those who developed AKI during hospitalization compared to those who were already admitted with AKI. CONCLUSION: It is possible to conclude that most patients undergoing RRT due to AKI are under 2 years of age and more than 50% have comorbidities. The presence of comorbidities and PIM2 are related to mortality.

The journey of breast cancer patient from self-perception of breast abnormalities to first cancer treatment- a sectional study in Sul Fluminense region-RJ-Brazil

Breast cancer is the most common female neoplasm in Brazil accounting for 73.610 new cases a year. The organization of public health system is a critical point to provide diagnosis and treatment for these patients, considering that 75% of the population is covered by public health system (Sistema Único de Saúde, SUS). Waiting time for diagnosis procedures and treatment has been used to evaluate accessibility to the health system and can guide governmental strategies to improve them. A retrospective study was conducted by assessing medical records of all patients registered at a High Complexity Oncology Assistance Unit (Unidade de Alta Complexidade em Oncologia, UNACON). The patients registered in the period from October 2021 to September 2022 were included. The medical report was used to collect epidemiological, clinicopathologic data, and main waiting times for diagnosis procedures and treatment. There were registered 143 patients, mean age was 57.6 years (SD±12,6). Symptoms detected cancer was the majority with 112 patients (86,8%). Median waiting times: 1-from breast abnormalities self-perception to first image exam was 60 days; 2-waiting time from the exam to core biopsy was 41,5 days; 3-waiting time from the biopsy to report liberation of biopsy was 11.0 days; 4-waiting time from biopsy report to first visit at oncologic care unit was 31.0 days; 4-waiting time from the oncologic care unit first visit to first treatment was 55.0 days; 5-waiting time from the breast biopsy to treatment beginning was 97.0 days. Our study demonstrates long waiting time from diagnosis to first treatment (above 60 days as established by Brazilian law) and long waiting time spending with each step of journey from the breast abnormalities self-detected to treatment beginning. Integration among basic, secondary and high complexity units, and clear strategies to guide patients with self-detected symptoms are points to be target.

Puesta en marcha de una unidad COVID de alto riesgo. La experiencia de un hospital general

Puesta en marcha de una unidad COVID de alto riesgo. La experiencia de un hospital general

Oncologic Disease in Patients at the High Complexity Oncology Unit (UNACON) of Amapá, Amazon, Brazil, between 2019 and 2022

Cancer is a chronic disease of significant and growing magnitude. This serious public health problem accounts for approximately 30% of all premature deaths from Non-Communicable Chronic Diseases (NCDs). This study aimed to quantify oncological disease in patients at the Unidade de Alta Complexidade de Oncologia do Amapá (UNACON) between 2019 and 2022. It was an exploratory-descriptive study with quantitative analysis. A higher frequency of cancer was observed in females aged 46 to 55 years, with breast neoplasia being the most commonly identified type, and the primary treatments used were surgery and chemotherapy. Therefore, there is a need to focus on preventive and health promotion measures in primary care, as well as attention to the high-complexity unit in the state for structural improvements that can provide convenience, comfort, and a minimum level of privacy for patient and caregiver research.

Awareness for Increased Iodine Consumption – Current Status and Future Perspectives

Introduction: Previous studies have shown that the Azorean population presented a lack of iodine intake in children and pregnant women. This led organizations to initiate more efforts to increase awareness and provide solutions to this problem, particularly through the consumption of iodised salt. Objectives: To clarify the effectiveness of the implemented heath measures and what influenced the use of iodised salt. Methodology: Observational and cross-sectional study with the application of a questionnaire that surveys iodine consumption in people presenting to the Unidade de Saúde da Ilha do Faial, Azores, between November 9th and November 14th, 2020. Results: Out of 100 individuals, 49 consumed iodised salt and 51 individuals did not. The mean age of responders was 49,81 years old. 19 participants had a diagnosis of thyroid disease. A recommendation from a physician and/or a nutritionist was the main reason that influenced people to implement iodised salt in their diet (n=18; 36.7%). Out of the 51 participants who did not consume iodised salt, 21 (41.2%) did not know about the existence of iodised salt and 11 did not know the benefits of iodised salt (21.6%). 28 individuals (28%) stated that a health care professional had recommended them to implement iodised salt or a multivitamin supplement containing iodine in their diet as opposed to 66 (66%) who said they did not receive that recommendation. Individuals who had a recommendation by a health care professional to implement iodised salt or a multivitamin supplement containing iodine are 8 times more likely to utilize iodised salt (OR=8,138; CI 95% [2,764;23,967]). Conclusions: While it is a work in progress, the implementation of iodised salt in the Azorean’s diet has taken a step in the right direction. It was demonstrated that implementing the consumption of iodised salt, explaining its importance and creating awareness of iodine deficiency by a health care worker can be a powerful weapon to tackle iodine deficiency.

Rural Cardiac Screening: Leveraging Technology from a Previously Established Echocardiographic Network

Objectives: The authors review the history of two cardiac programs in Guatemala and Belize that were initiated by the late Dr. Francis Robicsek. Building upon his legacy, the aim of the rural cardiac screening program is to further extend the reach to those individuals disenfranchised from cardiac services.&#x0D; Methods: Complementary to the Nan Van Every Cardiology Diagnostic Network, screening stations are organized once a year at two cardiac echo stations in Guatemala and two clinics in Belize. Demographic information and medical history are collected; limited physical and diagnostic tests performed; and results are reviewed by a cardiologist and relayed to the participant. Participants with a suspected heart issue are referred to one of the cardiology and cardiac programs in Guatemala or Belize for in-depth evaluation. Education on cardiovascular diseases, signs, symptoms, and risk factors is provided, as well as healthy lifestyle habits. &#x0D; Results: Building upon successful cardiac programs in low resource settings lends the ability to expand the cardiovascular screening and awareness reach. Heart disease is brought to the forefront in communities where there is no previously known access and clinicians are educated to identify heart problems.&#x0D; Conclusion: The success of Unidad de Cirugía Cardiovascular de Guatemala (UNICAR) in Guatemala City, and the cardiology and cardiac surgical programs at Karl Heusner Memorial Hospital Authority in Belize, and the Nan Van Every Cardiology Diagnostic Network, are the cornerstones to scaling the expansion and encounter individuals who have little, if any, knowledge about cardiac diseases, signs, symptoms and prevention.