| Records |
| 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. |
| 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 |
d Department of Collective Health, Federal University of Rio Grande Do Norte , Natal , Brazil |
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| Language |
English |
Summary Language |
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Edition |
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| ISSN |
0963-8288 |
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| Notes |
PMID:26987029 |
Approved |
no |
| Call Number |
ref @ user @ |
Serial |
97680 |
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| Author |
Miguel, M.G.; Barreto, R.P.; Pereira, S.Y. |
| Title |
Study of a tropical soil in order to use it to retain aluminum, iron, manganese and fluoride from acid mine drainage |
Type |
Journal Article |
| Year |
2017 |
Publication |
Journal of Environmental Management |
Abbreviated Journal |
J Environ Manage |
| Volume |
204 |
Issue |
Pt 1 |
Pages |
563-570 |
| Keywords |
Acid mine drainage; Column test; Contaminant transport; Liner; Tropical soils; Waste rock pile |
| Abstract |
The Ore Treatment Unit (UTM-Caldas), in the city of Caldas, Minas Gerais, Brazil, nowadays in decommissioning stage, was the first uranium extraction mine in Brazil. Several negative environmental impacts in the area have occurred, because of mining, treatment and beneficiation processes. Waste rock pile 4 (WRP-4) generates acid mine drainage (AMD), which is discharged in the Nestor Figueiredo retention pond (NFP). However, leakage of acid water by the NFP dam foundation has been constantly observed. Therefore, this research aimed to investigate a typical tropical soil, in order to use it as mineral liner for the NFP to minimize the leakage of acid water through the dam foundation and to retain predominant chemical species. Geotechnical, chemical and mineralogical tests were performed to characterize the soil and a column test was carried out using the acid mine drainage as contaminant, which contained aluminum (Al), manganese (Mn), iron (Fe) and fluoride (F-). The soil presented micro aggregation, acid pH, and low values of organic matter content and cation exchange capacity, which are characteristics of highly weathered soils. Diffusion was the predominant transport mechanism in the column test. Effluent solutions with pH less than 6.0 indicated the formation of insoluble Al-F complexes in the soil and desorption of iron and manganese at concentrations above those allowed by the Brazilian legislation. At pH greater than 6.0, the desorption of iron and manganese and release of aluminum and fluoride in the free form occurred, with concentrations also higher than the allowed by the Brazilian legislation. |
| Address |
Institute of Geoscience, University of Campinas (Unicamp), Brazil |
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English |
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0301-4797 |
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| Notes |
PMID:28942188 |
Approved |
no |
| Call Number |
ref @ user @ |
Serial |
97504 |
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| Author |
Villalobos, A.M.; Barraza, F.; Jorquera, H.; Schauer, J.J. |
| Title |
Wood burning pollution in southern Chile: PM2.5 source apportionment using CMB and molecular markers |
Type |
Journal Article |
| Year |
2017 |
Publication |
Environmental Pollution (Barking, Essex : 1987) |
Abbreviated Journal |
Environ Pollut |
| Volume |
225 |
Issue |
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Pages |
514-523 |
| Keywords |
Aerosols/analysis; Air Pollutants/*analysis; Chile; Cities; Coal; Dust; *Environmental Monitoring; Fires; Heating; Nitrates/analysis; Particulate Matter/*analysis; Seasons; Smoke; Sulfates/analysis; Wood/chemistry; Cmb-Mm; Fuel poverty; Source apportionment; Southern Chile; Sustainable urban development; Wood burning |
| Abstract |
Temuco is a mid-size city representative of severe wood smoke pollution in southern Chile; i.e., ambient 24-h PM2.5 concentrations have exceeded 150 mug/m3 in the winter season and the top concentration reached 372 mug/m3 in 2010. Annual mean concentrations have decreased but are still above 30 mug/m3. For the very first time, a molecular marker source apportionment of ambient organic carbon (OC) and PM2.5 was conducted in Temuco. Primary resolved sources for PM2.5 were wood smoke (37.5%), coal combustion (4.4%), diesel vehicles (3.3%), dust (2.2%) and vegetative detritus (0.7%). Secondary inorganic PM2.5 (sulfates, nitrates and ammonium) contributed 4.8% and unresolved organic aerosols (generated from volatile emissions from incomplete wood combustion), including secondary organic aerosols, contributed 47.1%. Adding the contributions of unresolved organic aerosols to those from primary wood smoke implies that wood burning is responsible for 84.6% of the ambient PM2.5 in Temuco. This predominance of wood smoke is ultimately due to widespread poverty and a lack of efficient household heating methods. The government has been implementing emission abatement policies but achieving compliance with ambient air quality standards for PM2.5 in southern Chile remains a challenge. |
| Address |
Environmental Chemistry and Technology Program, University of Wisconsin-Madison, 660 North Park Street, Madison, WI 53706, USA |
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English |
Summary Language |
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Edition |
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0269-7491 |
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| Notes |
PMID:28318790 |
Approved |
no |
| Call Number |
ref @ user @ |
Serial |
97509 |
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| Author |
Harling, G.; Lima Neto, A.S.; Sousa, G.S.; Machado, M.M.T.; Castro, M.C. |
| Title |
Determinants of tuberculosis transmission and treatment abandonment in Fortaleza, Brazil |
Type |
Journal Article |
| Year |
2017 |
Publication |
BMC Public Health |
Abbreviated Journal |
BMC Public Health |
| Volume |
17 |
Issue |
1 |
Pages |
508 |
| Keywords |
Brazil; Epidemiology; Fortaleza; Social determinants; Spatial analysis; Treatment; Treatment failure; Tuberculosis |
| Abstract |
BACKGROUND: Tuberculosis (TB) remains a public health problem, despite recent achievements in reducing incidence and mortality rates. In Brazil, these achievements were above the worldwide average, but marked by large regional heterogeneities. In Fortaleza (5th largest city in Brazil), the tuberculosis cure rate has been declining and treatment abandonment has been increasing in the past decade, despite a reduction in incidence and an increase in directly observed therapy (DOT). These trends put efforts to eliminate tuberculosis at risk. We therefore sought to determine social and programmatic determinants of tuberculosis incidence and treatment abandonment in Fortaleza. METHODS: We analyzed sociodemographic and clinical data for all new tuberculosis cases notified in the Notifiable Diseases Information System (SINAN) from Fortaleza between 2007 and 2014. We calculated incidence rates for 117 neighborhoods in Fortaleza, assessed their spatial clustering, and used spatial regression models to quantify associations between neighborhood-level covariates and incidence rates. We used hierarchical logistic regression models to evaluate how individual- and neighborhood-level covariates predicted tuberculosis treatment abandonment. RESULTS: There were 12,338 new cases reported during the study period. Case rates across neighborhoods were significantly positively clustered in two low-income areas close to the city center. In an adjusted model, tuberculosis rates were significantly higher in neighborhoods with lower literacy, higher sewerage access and homicide rates, and a greater proportion of self-reported black residents. Treatment was abandoned in 1901 cases (15.4%), a rate that rose by 71% between 2007 and 2014. Abandonment was significantly associated with many individual sociodemographic and clinical factors. Notably, being recommended for DOT was protective for those who completed DOT, but associated with abandonment for those who did not. CONCLUSION: Low socioeconomic status areas have higher tuberculosis rates, and low socioeconomic individuals have higher risk of treatment abandonment, in Fortaleza. Treatment abandonment rates are growing despite the advent of universal DOT recommendations in Brazil. Proactive social policies, and active contact tracing to find missed cases, may help reduce the tuberculosis burden in this setting. |
| Address |
Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Building I, Room 1113, Boston, MA, 02115, USA. mcastro@hsph.harvard.edu |
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English |
Summary Language |
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1471-2458 |
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| Notes |
PMID:28545423 |
Approved |
no |
| Call Number |
ref @ user @ |
Serial |
97635 |
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Azoulay, M.; Santos, F.; Shenouda, G.; Petrecca, K.; Oweida, A.; Guiot, M.C.; Owen, S.; Panet-Raymond, V.; Souhami, L.; Abdulkarim, B.S. |
| Title |
Benefit of re-operation and salvage therapies for recurrent glioblastoma multiforme: results from a single institution |
Type |
Journal Article |
| Year |
2017 |
Publication |
Journal of Neuro-Oncology |
Abbreviated Journal |
J Neurooncol |
| Volume |
132 |
Issue |
3 |
Pages |
419-426 |
| Keywords |
Bevacizumab; Glioblastoma; Radiation; Recurrence; Surgery; Temozolomide |
| Abstract |
The optimal management of recurrent glioblastoma (GBM) has yet to be determined. We aim to assess the benefits of re-operation and salvage therapies (chemotherapy and/or re-irradiation) for recurrent GBM and to identify prognostic factors associated with better survival. All patients who underwent surgery for GBM between January 2005 and December 2012 followed by adjuvant radiotherapy, and who developed GBM recurrence on imaging were included in this retrospective study. Univariate and multivariate analysis was performed using Cox models in order to identify factors associated with overall survival (OS). One hundred and eighty patients treated to a dose of 60 Gy were diagnosed with recurrent GBM. At a median follow-up time of 6.2 months, the median survival (MS) from time of recurrence was 6.6 months. Sixty-nine patients underwent repeat surgery for recurrence based on imaging. To establish the benefits of repeat surgery and salvage therapies, 68 patients who underwent repeat surgery were matched to patients who did not based on extent of initial resection and presence of subventricular zone involvement at recurrence. MS for patients who underwent re-operation was 9.6 months, compared to 5.3 months for patients who did not have repeat surgery (p < 0.0001). Multivariate analysis in the matched pairs confirmed that repeat surgery with the addition of other salvage treatment can significantly affect patient outcome (HR 0.53). Re-operation with additional salvage therapies for recurrent GBM provides survival prolongation at the time of progression. |
| Address |
Department of Oncology, Division of Radiation Oncology, Cedars Cancer Centre, McGill University Health Centre, 1001 Decarie Boulevard, Montreal, QC, H4A 3J1, Canada. bassam.abdulkarim@mcgill.ca |
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English |
Summary Language |
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Edition |
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0167-594X |
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| Notes |
PMID:28374095 |
Approved |
no |
| Call Number |
ref @ user @ |
Serial |
96599 |
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