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Sousa, K. de M.; Oliveira, W.I.F. de; Melo, L.O.M. de; Alves, E.A.; Piuvezam, G.; Gama, Z.A. da S. |
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Title |
A qualitative study analyzing access to physical rehabilitation for traffic accident victims with severe disability in Brazil |
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Journal Article |
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Year |
2017 |
Publication  |
Disability and Rehabilitation |
Abbreviated Journal |
Disabil Rehabil |
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Volume |
39 |
Issue |
6 |
Pages |
568-577 |
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Keywords |
Brazil; health services accessibility; quality of health care; rehabilitation; traffic accidents |
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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. |
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d Department of Collective Health, Federal University of Rio Grande Do Norte , Natal , Brazil |
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0963-8288 |
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PMID:26987029 |
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Call Number |
ref @ user @ |
Serial |
97458 |
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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. |
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Title |
A qualitative study analyzing access to physical rehabilitation for traffic accident victims with severe disability in Brazil |
Type |
Journal Article |
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Year |
2017 |
Publication |
Disability and Rehabilitation |
Abbreviated Journal |
Disabil Rehabil |
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Volume |
39 |
Issue |
6 |
Pages |
568-577 |
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Keywords |
Brazil; health services accessibility; quality of health care; rehabilitation; traffic accidents |
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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. |
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d Department of Collective Health, Federal University of Rio Grande Do Norte , Natal , Brazil |
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0963-8288 |
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PMID:26987029 |
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Call Number |
ref @ user @ |
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97680 |
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Author |
Fuster, M. |
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“We like Fried Things”: Negotiating Health and Taste among Hispanic Caribbean Communities in New York City |
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Journal Article |
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Year |
2017 |
Publication |
Ecology of Food and Nutrition |
Abbreviated Journal |
Ecol Food Nutr |
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56 |
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2 |
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124-138 |
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Keywords |
Adult; *Cooking; Cuba; Dominican Republic; Female; *Food Analysis; *Food Preferences; Hispanic Americans; Humans; Male; New York City; Puerto Rico; Taste; Young Adult; Emigration and immigration; Hispanic Americans; New York City; qualitative research |
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Abstract |
The study was conducted to understand fried-food (FF) consumption among Hispanic Caribbean (HC) communities in New York City. Data were collected through qualitative interviews with 23 adults self-identified as Cuban, Dominican, or Puerto Rican. Most informants considered FFs an important part of their traditional diet. Potential explanations included taste, cost, convenience, and the emotive values attached to FF. FF consumption was contextualized in local foodscapes. Results include strategies to diminish FF consumption and differences across HC groups and migratory generations. The relevance for future nutrition interventions addressing health disparities in this community is discussed. |
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a Department of Health and Nutrition Sciences , City University of New York-Brooklyn College , Brooklyn , New York , USA |
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0367-0244 |
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PMID:28059558 |
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Call Number |
ref @ user @ |
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98032 |
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Griboff, J.; Horacek, M.; Wunderlin, D.A.; Monferran, M.V. |
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Bioaccumulation and trophic transfer of metals, As and Se through a freshwater food web affected by antrophic pollution in Cordoba, Argentina |
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Journal Article |
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2017 |
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Ecotoxicology and Environmental Safety |
Abbreviated Journal |
Ecotoxicol Environ Saf |
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148 |
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275-284 |
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Aquatic organisms; As; Biomagnification; Food web; Metals; Stable isotopes |
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The concentration of metals (Al, Cr, Mn, Fe, Ni, Cu, Zn, Ag, Cd, Hg, Pb, U), As and Se in different ecosystem components (water, sediment, plankton, shrimp, and fish muscle) has been determined in a eutrophic reservoir in the Province of Cordoba (Argentina). Los Molinos Lake (LML) was sampled during the dry (DS) and wet seasons (WS) in order to examine the bioaccumulation and transfer of these inorganic elements through the food web. Stable nitrogen isotope (delta15N) was used to investigate trophic interactions. According to this, samples were divided into three categories: plankton, shrimp (Palaemonetes argentinus) and fish (Silverside, Odontesthes bonariensis). The bioaccumulation factor (BAF) was calculated for the organisms, and it was determined that the elements analyzed undergo bioaccumulation, especially in organisms such as plankton. The invertebrates were characterized by the highest BAF for Cu and Zn in both seasons, As (DS), and Cd and Hg (WS). The fish muscle was characterized by the highest BAF for Se (WS), Ag and Hg (DS). On the other hand, a significant decrease in Al, Cr, Mn, Fe, Ni, Cu, Zn, As, Se, Cd and U concentrations through the analyzed trophic web during both seasons was observed. Moreover, a significant increase in Hg levels was observed with increasing trophic levels in the DS, indicating its biomagnification. Despite the increasing impact of metals, As and Se pollution in the studied area due to urban growth and agricultural and livestock activities, no previous study has focused on the behavior and relationships of these pollutants with the biotic and abiotic components of this aquatic reservoir. We expect that these findings may be used for providing directions or guidance for future monitoring and environmental protection policies. |
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ICYTAC, Instituto de Ciencia y Tecnologia de Alimentos Cordoba, CONICET and Facultad de Ciencias Quimicas, Universidad Nacional de Cordoba, Bv. Dr. Juan Filloy s/n, Ciudad Universitaria, 5000 Cordoba, Argentina. Electronic address: mmonferran@fcq.unc.edu.ar |
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0147-6513 |
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PMID:29078130 |
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ref @ user @ |
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98006 |
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Author |
Radbel, J.; Boutsikaris, D. |
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The New Usual Care |
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Journal Article |
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Year |
2017 |
Publication |
Emergency Medicine Clinics of North America |
Abbreviated Journal |
Emerg Med Clin North Am |
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35 |
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1 |
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11-23 |
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Anti-Bacterial Agents/therapeutic use; Catheterization, Central Venous; Clinical Protocols/standards; Evidence-Based Medicine; Fluid Therapy; Humans; Sepsis/diagnosis/*therapy; ARISE trial; Early goal-directed therapy (EGDT); ProCESS trial; ProMISe trial; Sepsis; Usual care |
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Recent literature continues to refine which components of the early goal-directed therapy (EGDT) algorithm are necessary. Given it utilizes central venous pressure, continuous central venous oxygen saturation, routine blood transfusions, and inotropic medications, this algorithm can be timely, invasive, costly, and potentially harmful. New trials highlight early recognition, early fluid resuscitation, appropriate antibiotic treatment, source control, and the application of a multidisciplinary evidence-based approach as essential components of current sepsis management. This article discusses the landmark sepsis trials that have been published over the past several decades and offers recommendations on what should currently be considered 'usual care'. |
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Department of Emergency Medicine, Saint Peters University Hospital, 254 Easton Ave, New Brunswick, NJ 08901, USA; Division of Pulmonary and Critical Care, Department of Medicine, Rutgers Robert Wood Johnson Medical School, One Robert Johnson Place, New Brunswick, NJ 08903, USA. Electronic address: boutsida@rwjms.rutgers.edu |
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0733-8627 |
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PMID:27908328 |
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ref @ user @ |
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99263 |
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