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Author Sousa, K. de M.; Oliveira, W.I.F. de; Melo, L.O.M. de; Alves, E.A.; Piuvezam, G.; Gama, Z.A. da S. url  doi
openurl 
  Title A qualitative study analyzing access to physical rehabilitation for traffic accident victims with severe disability in Brazil Type Journal Article
  Year 2017 Publication Disability and Rehabilitation Abbreviated Journal Disabil Rehabil  
  Volume 39 Issue 6 Pages 568-577  
  Keywords Brazil; health services accessibility; quality of health care; rehabilitation; traffic accidents  
  Abstract Purpose To identify access barriers to physical rehabilitation for traffic accident (TA) victims with severe disability and build a theoretical model to provide guidance towards the improvement of these services. Methods Qualitative research carried out in the city of Natal (Northeast Brazil), with semi-structured interviews with 120 subjects (19 key informer health professionals and 101 TA victims) identified in a database made available by the emergency hospital. The interviews were analyzed using Alceste software, version 4.9. Results The main barriers present in the interviews were: (1) related to services: bureaucratic administrative practises, low offer of rehabilitation services, insufficient information on rehabilitation, lack of guidelines that integrate hospital and ambulatory care and (2) related to patients: financial difficulties, functional limitations, geographic distance, little information on health, association with low education levels and disbelief in the system and in rehabilitation. Conclusion The numerous access barriers were presented in a theoretical model with causes related to organizational structure, processes of care, professionals and patients. This model must be tested by health policy-makers and managers to improve the quality of physical rehabilitation and avoid unnecessary prolongation of the suffering and disability experienced by TA survivors. Implications for rehabilitation Traffic accidents (TAs) are a global health dilemma that demands integrality of preventive actions, pre-hospital and hospital care and physical rehabilitation (PR). This study lays the foundation for improving access to PR for TA survivors, an issue of quality of care that results in preventable disabilities. The words of the patients interviewed reveal the suffering of victims, which is often invisible to society and given low priority by health policies that relegate PR to a second plan ahead of prevention and urgent care. A theoretical model of the causes of the problem of access to PR was built. The identified barriers are potentially preventable through the intervention of health policy-makers, managers, regulators and rehabilitation professionals, and by encouraging the participation of patients. Addressing timely access barriers involves the expansion of the supply of services and rehabilitation professionals, regulation and standardization of referencing practises and encouraging the provision of information to patients about continuity of care and their health needs.  
  Address (up) d Department of Collective Health, Federal University of Rio Grande Do Norte , Natal , Brazil  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 0963-8288 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:26987029 Approved no  
  Call Number ref @ user @ Serial 97680  
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Author Brodie, S.; Lee, H.K.; Jiang, W.; Cazacu, S.; Xiang, C.; Poisson, L.M.; Datta, I.; Kalkanis, S.; Ginsberg, D.; Brodie, C. url  doi
openurl 
  Title The novel long non-coding RNA TALNEC2, regulates tumor cell growth and the stemness and radiation response of glioma stem cells Type Journal Article
  Year 2017 Publication Oncotarget Abbreviated Journal Oncotarget  
  Volume 8 Issue 19 Pages 31785-31801  
  Keywords Talnec2; glioblastoma; glioma stem cells; long non-cording RNAs; mesenchymal transformation  
  Abstract Despite advances in novel therapeutic approaches for the treatment of glioblastoma (GBM), the median survival of 12-14 months has not changed significantly. Therefore, there is an imperative need to identify molecular mechanisms that play a role in patient survival. Here, we analyzed the expression and functions of a novel lncRNA, TALNEC2 that was identified using RNA seq of E2F1-regulated lncRNAs. TALNEC2 was localized to the cytosol and its expression was E2F1-regulated and cell-cycle dependent. TALNEC2 was highly expressed in GBM with poor prognosis, in GBM specimens derived from short-term survivors and in glioma cells and glioma stem cells (GSCs). Silencing of TALNEC2 inhibited cell proliferation and arrested the cells in the G1\S phase of the cell cycle in various cancer cell lines. In addition, silencing of TALNEC2 decreased the self-renewal and mesenchymal transformation of GSCs, increased sensitivity of these cells to radiation and prolonged survival of mice bearing GSC-derived xenografts. Using miRNA array analysis, we identified specific miRNAs that were altered in the silenced cells that were associated with cell-cycle progression, proliferation and mesenchymal transformation. Two of the downregulated miRNAs, miR-21 and miR-191, mediated some of TALNEC2 effects on the stemness and mesenchymal transformation of GSCs. In conclusion, we identified a novel E2F1-regulated lncRNA that is highly expressed in GBM and in tumors from patients of short-term survival. The expression of TALNEC2 is associated with the increased tumorigenic potential of GSCs and their resistance to radiation. We conclude that TALNEC2 is an attractive therapeutic target for the treatment of GBM.  
  Address (up) Davidson Laboratory of Cell Signaling and Tumorigenesis, Hermelin Brain Tumor Center, Department of Neurosurgery, Detroit, MI, USA  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 1949-2553 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:28423669 Approved no  
  Call Number ref @ user @ Serial 96594  
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Author Ribeiro, A.P.; Souza, E.R. de; Sousa, C.A.M. de url  doi
openurl 
  Title Injuries caused by firearms treated at Brazilian urgent and emergency healthcare services Type Journal Article
  Year 2017 Publication Ciencia & Saude Coletiva Abbreviated Journal Cien Saude Colet  
  Volume 22 Issue 9 Pages 2851-2860  
  Keywords  
  Abstract This paper analyzes the medical care given at Brazilian urgent and emergency healthcare services to people injured by firearms in 2014. A cross-sectional study was carried out on care given to patients with firearms injuries in 24 capital cities of Brazilian states and in the Brazilian Federal District, included in the VIVA Survey. Simple and relative frequencies of the variables related to the patients and to the event were calculated, and a logistic model for complex samples was applied adopting care for firearms injuries patients as outcome. The results show the following percentages of care events as caused by firearms: 0.7% for the category 'other accidents (other than transport-related accidents)', 1.5% for self-inflicted injuries, 15.9% for injuries due to assault, and 65.1% of cases arising from legal intervention. The care given was predominantly to young male adults (age 20-39), of mixed race and with a low level of schooling. The most common injuries were: to arms and legs; and to multiple organs. The paper concludes by discussing the efforts to control firearms held by the public in Brazil, and how they can lead to severe and lethal outcomes in quarrels and interpersonal disputes.  
  Address (up) Departamento de Estudos sobre Violencia e Saude Jorge Careli/Claves, Escola Nacional de Saude Publica, Fiocruz. Av. Brasil 4036/7 masculine, Manguinhos. 21040-210 Rio de Janeiro RJ Brasil. adalpeixoto@yahoo.com.br  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title Lesoes provocadas por armas de fogo atendidas em servicos de urgencia e emergencia brasileiros  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 1413-8123 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:28954136 Approved no  
  Call Number ref @ user @ Serial 97503  
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Author Girardi, S.N.; Carvalho, C.L.; Maas, L.W.D.; Araujo, J.F.; Massote, A.W.; Stralen, A.C. de S. van; Souza, O.A. de url  doi
openurl 
  Title [Preferences for work in primary care among medical students in Minas Gerais State, Brazil: evidence from a discrete choice experiment] Type Journal Article
  Year 2017 Publication Cadernos de Saude Publica Abbreviated Journal Cad Saude Publica  
  Volume 33 Issue 8 Pages e00075316  
  Keywords Brazil; *Career Choice; Choice Behavior; Female; Humans; Income; Male; *Primary Health Care; *Professional Practice Location; Sex Factors; *Students, Medical; Surveys and Questionnaires  
  Abstract This article presents the results of a discrete choice experiment (DCE) conducted in 2012 with 277 final-year medical students from Minas Gerais State, Brazil. The experiment tested students' preferences concerning future work as physicians in primary health care, based on hypothetical job scenarios aimed at measuring the likelihood of placement in areas with a shortage of doctors. Application of DCE involved (i) a qualitative stage to define the attributes and their respective levels to comprise the job scenarios, (ii) construction and application of the instrument, and (iii) analysis with application of multinomial logit with conditional probability to estimate the weight of attributes and to construct scenarios for choice probability. The results indicate that the job attribute that most impacted students' choice was location, followed by job conditions, pay, access to medical residency, type of employment relationship, and workload. Students from private medical schools, with higher family income, and females were generally more likely to resist job assignments in unsafe urban areas and remote areas of the countryside. The job scenarios that proved most plausible in terms of public intervention were those that combined middle-level wages, good working conditions, and 10 to 20 bonus points on medical residency exams.  
  Address (up) Departamento de Matematica, Universidade Estadual do Centro-Oeste, Guarapuava, Brasil  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language Portuguese Summary Language Original Title Preferencias para o trabalho na atencao primaria por estudantes de medicina em Minas Gerais, Brasil: evidencias de um experimento de preferencia declarada  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 0102-311X ISBN Medium  
  Area Expedition Conference  
  Notes PMID:28832780 Approved no  
  Call Number ref @ user @ Serial 97630  
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Author Nunes, B.P.; Soares, M.U.; Wachs, L.S.; Volz, P.M.; Saes, M. de O.; Duro, S.M.S.; Thume, E.; Facchini, L.A. url  doi
openurl 
  Title Hospitalization in older adults: association with multimorbidity, primary health care and private health plan Type Journal Article
  Year 2017 Publication Revista de Saude Publica Abbreviated Journal Rev Saude Publica  
  Volume 51 Issue Pages 43  
  Keywords Aged; Brazil; *Comorbidity; Cross-Sectional Studies; Female; Hospitalization/*statistics & numerical data; Humans; Male; Middle Aged; Prepaid Health Plans/*statistics & numerical data; Primary Health Care/*standards/statistics & numerical data; Socioeconomic Factors; Urban Population  
  Abstract OBJECTIVE: Evaluate the association of multimorbidity, primary health care model and possession of a private health plan with hospitalization. METHODS: A population-based cross-sectional study with 1,593 elderly individuals (60 years old or older) living in the urban area of the city of Bage, State of Rio Grande do Sul, Brazil. The outcome was hospitalization in the year preceding the interview. The multimorbidity was evaluated through two cut-off points (>/= 2 and >/= 3). The primary health care model was defined by residence in areas covered by traditional care or by Family Health Strategy. The older adults mentioned the possession of a private health plan. We performed a gross and adjusted analysis by Poisson regression using a hierarchical model. The adjustment included demographic, socioeconomic, functional capacity disability and health services variables. RESULTS: The occurrence of overall and non-surgical hospitalization was 17.7% (95%CI 15.8-19.6) and 10.6% (95%CI 9.1-12.1), respectively. Older adults with multimorbidity were admitted to hospitals more often when to older adults without multimorbidity, regardless of the exhibition' form of operation. Having a private health plan increased the hospitalization by 1.71 (95%CI 1.09-2.69) times among residents in the areas of the Family Health Strategy when compared to elderly residents in traditional areas without a private health plan. CONCLUSIONS: The multimorbidity increased the occurrence of hospitalizations, especially non-surgical ones. Hospitalization was more frequent in older adults with private health plan and those living in Family Health Strategy areas, regardless of the presence of multiple diseases. OBJETIVO: Avaliar a associacao da multimorbidade, modelo de atencao basica e posse de plano de saude com hospitalizacao. METODOS: Estudo transversal de base populacional com 1.593 idosos (60 anos ou mais) residentes na zona urbana do municipio de Bage, Rio Grande do Sul. O desfecho foi a hospitalizacao no ano anterior a entrevista. A multimorbidade foi avaliada por meio de dois pontos de corte (>/= 2 e >/= 3). O modelo de atencao basica foi definido pela residencia em areas cobertas pela atencao tradicional ou da Estrategia Saude da Familia. A posse de plano de saude foi referida pelos idosos. Realizou-se analise bruta e ajustada por regressao de Poisson utilizando modelo hierarquizado. O ajuste incluiu variaveis demograficas, socioeconomicas, capacidades funcionais e de servicos de saude. RESULTADOS: A ocorrencia de hospitalizacao geral e nao cirurgica foi de 17,7% (IC95% 15,8-19,6) e 10,6% (IC95% 9,1-12,1), respectivamente. Idosos com multimorbidade hospitalizaram mais em comparacao com os idosos sem multimorbidade, independentemente da forma de operacionalizacao da exposicao. O plano de saude aumentou em 1,71 (IC95% 1,09-2,69) vezes a internacao hospitalar entre residentes nas areas da Estrategia Saude da Familia em comparacao aos idosos residentes nas areas tradicionais sem plano de saude. CONCLUSOES: A multimorbidade aumentou a ocorrencia de hospitalizacoes, principalmente aquelas nao cirurgicas. Idosos com plano de saude e residentes em areas de Estrategia Saude da Familia internaram mais, independentemente da presenca de multiplas doencas.  
  Address (up) Departamento de Medicina Social. Faculdade de Medicina. Universidade Federal de Pelotas. Pelotas, RS, Brasil  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language Portuguese Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 0034-8910 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:28492761 Approved no  
  Call Number ref @ user @ Serial 97638  
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