| Records |
| Author |
Gragnani, A.; de Oliveira, A.F.; Boro, D.; Pham, T.N.; Ferreira, L.M. |
| Title |
Response and legislative changes after the Kiss nightclub tragedy in Santa Maria/RS/Brazil: Learning from a large-scale burn disaster |
Type |
Journal Article |
| Year |
2017 |
Publication |
Burns : Journal of the International Society for Burn Injuries |
Abbreviated Journal |
Burns |
| Volume |
43 |
Issue |
2 |
Pages |
343-349 |
| Keywords |
Brazil/epidemiology; Burns/epidemiology/*prevention & control; Carbon Monoxide Poisoning/epidemiology; Crowding; Disasters/*prevention & control; Fires/legislation & jurisprudence/*prevention & control; Humans; Hydrolases/poisoning; Mass Casualty Incidents/*prevention & control/statistics & numerical data; *Public Policy; Retrospective Studies; Safety/*legislation & jurisprudence; Smoke Inhalation Injury/epidemiology; Burn disaster; Fire prevention and protection; Kiss nightclub; Legislation; Mass casualty incident; Santa Maria |
| Abstract |
PURPOSE: A major fire occurred on January 27, 2013, at 02:30 at Kiss nightclub in the city of Santa Maria, State of Rio Grande do Sul, in Southern Brazil. In this retrospective report, we aimed to describe the nightclub fire event, its immediate consequences, and evaluated its impact on legislation. Our objective was to disseminate the lessons we learned from this large-scale nightclub fire disaster. METHODS: We conducted a literature review in PubMed and Lilacs database from 2013 to 2015 related to the nightclub Kiss, Santa Maria, fire, burns, and similar events worldwide over the past 15 years. We searched in the general press and online media information sites, and seeking legislation about this topic at the federal level in Brazil. We reported on the legislation changes that resulted from this nightclub fire. RESULTS: Current federal legislation on fire prevention and the scope of public safety, including night clubs and discos, states is the duty of the state and everyone's responsibility, pursuant to Article 144 of the Federal Constitution of Brazil. Thus, the federal union, individual states and municipalities have the power to legislate on fire prevention, and especially to ensure the security of the population. A state law called “Law Kiss”, was passed in 2014, establishing standards on safety, prevention and protection against fire in buildings and areas of fire risk in the state of Rio Grande do Sul. On a national level, a law of prevention and fire fighting in Brazil was also drafted after the Santa Maria disaster (Law project no. 4923, 2013). Currently, this bill is still awaiting sanction before it can take effect. CONCLUSION: As we push for enactment of the national law of prevention and fire fighting in Brazil, we will continue emphasizing fire prevention, fire protection, fire fighting, means of escape and proper management. All similar events in this and other countries remind us that similar tragedies may occur anywhere, and that the analysis of facts, previous mistakes, during and after the incident are crucial to our understanding, and will help us lessen the chance of future occurrences. |
| Address |
Universidade Federal de Sao Paulo, Escola Paulista de Medicina, Brazil |
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English |
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| ISSN |
0305-4179 |
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| Notes |
PMID:27663506 |
Approved |
no |
| Call Number |
ref @ user @ |
Serial  |
97661 |
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| Author |
Del Brutto, O.H.; Mera, R.M.; Zambrano, M.; Del Brutto, V.J. |
| Title |
Severe edentulism is a major risk factor influencing stroke incidence in rural Ecuador (The Atahualpa Project) |
Type |
Journal Article |
| Year |
2017 |
Publication |
International Journal of Stroke : Official Journal of the International Stroke Society |
Abbreviated Journal |
Int J Stroke |
| Volume |
12 |
Issue |
2 |
Pages |
201-204 |
| Keywords |
Adult; Comorbidity; Ecuador/epidemiology; Female; Follow-Up Studies; Humans; Hypertension/complications/epidemiology; Incidence; Male; Middle Aged; Mouth, Edentulous/complications/*epidemiology; Prospective Studies; Risk Factors; Rural Population; Severity of Illness Index; Stroke/complications/*epidemiology; Ecuador; Stroke incidence; cohort study; edentulism; stroke risk factors |
| Abstract |
Background There is no information on stroke incidence in rural areas of Latin America, where living conditions and cardiovascular risk factors are different from urban centers. Aim Using a population-based prospective cohort study design, we aimed to assess risk factors influencing stroke incidence in community-dwelling adults living in rural Ecuador. Methods First-ever strokes occurring from 1 June 2012 to 31 May 2016, in Atahualpa residents aged >/=40 years, were identified from yearly door-to-door surveys and other overlapping sources. Poisson regression models adjusted for demographics, cardiovascular risk factors, edentulism and the length of observation time per subject were used to estimate stroke incidence rate ratio as well as factors influencing such incidence. Results Of 807 stroke-free individuals prospectively enrolled in the Atahualpa Project, follow-up was achieved in 718 (89%), contributing 2,499 years of follow-up (average 3.48 +/- 0.95 years). Overall stroke incidence rate was 2.97 per 100 person-years of follow-up (95% CI: 1.73-4.2), which increased to 4.77 (95% CI: 1.61-14.1) when only persons aged >/=57 years were considered. Poisson regression models, adjusted for relevant confounders, showed that high blood pressure (IRR: 5.24; 95% CI: 2.55-7.93) and severe edentulism (IRR: 5.06; 95% CI: 2.28-7.85) were the factors independently increasing stroke incidence. Conclusions Stroke incidence in this rural setting is comparable to that reported from the developed world. Besides age and high blood pressure, severe edentulism is a major factor independently predicting incident strokes. Public awareness of the consequences of poor dental care might reduce stroke incidence in rural settings. |
| Address |
4 Department of Neurology, University of Chicago, Chicago, IL, USA |
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English |
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1747-4930 |
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| Notes |
PMID:27777377 |
Approved |
no |
| Call Number |
ref @ user @ |
Serial |
97655 |
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| Author |
Barros, J.; Morales, S.; Echavarri, O.; Garcia, A.; Ortega, J.; Asahi, T.; Moya, C.; Fischman, R.; Maino, M.P.; Nunez, C. |
| Title |
Suicide detection in Chile: proposing a predictive model for suicide risk in a clinical sample of patients with mood disorders |
Type |
Journal Article |
| Year |
2017 |
Publication |
Revista Brasileira de Psiquiatria (Sao Paulo, Brazil : 1999) |
Abbreviated Journal |
Rev Bras Psiquiatr |
| Volume |
39 |
Issue |
1 |
Pages |
1-11 |
| Keywords |
Adolescent; Adult; Chile; Female; Humans; Male; Mental Disorders/complications/*psychology; Middle Aged; Models, Theoretical; Risk Factors; Sensitivity and Specificity; Socioeconomic Factors; Suicide/*prevention & control; Surveys and Questionnaires; Young Adult |
| Abstract |
Objective:: To analyze suicidal behavior and build a predictive model for suicide risk using data mining (DM) analysis. Methods:: A study of 707 Chilean mental health patients (with and without suicide risk) was carried out across three healthcare centers in the Metropolitan Region of Santiago, Chile. Three hundred forty-three variables were studied using five questionnaires. DM and machine-learning tools were used via the support vector machine technique. Results:: The model selected 22 variables that, depending on the circumstances in which they all occur, define whether a person belongs in a suicide risk zone (accuracy = 0.78, sensitivity = 0.77, and specificity = 0.79). Being in a suicide risk zone means patients are more vulnerable to suicide attempts or are thinking about suicide. The interrelationship between these variables is highly nonlinear, and it is interesting to note the particular ways in which they are configured for each case. The model shows that the variables of a suicide risk zone are related to individual unrest, personal satisfaction, and reasons for living, particularly those related to beliefs in one's own capacities and coping abilities. Conclusion:: These variables can be used to create an assessment tool and enables us to identify individual risk and protective factors. This may also contribute to therapeutic intervention by strengthening feelings of personal well-being and reasons for staying alive. Our results prompted the design of a new clinical tool, which is fast and easy to use and aids in evaluating the trajectory of suicide risk at a given moment. |
| Address |
Private practice |
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English |
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Edition |
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1516-4446 |
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| Notes |
PMID:27783715 |
Approved |
no |
| Call Number |
ref @ user @ |
Serial |
97654 |
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| Author |
LaGrone, L.N.; Isquith-Dicker, L.N.; Huaman Egoavil, E.; Rodriguez Castro, M.J.A.; Allagual, A.; Revoredo, F.; Mock, C.N. |
| Title |
Surgeons' and Trauma Care Physicians' Perception of the Impact of the Globalization of Medical Education on Quality of Care in Lima, Peru |
Type |
Observational Study |
| Year |
2017 |
Publication |
JAMA Surgery |
Abbreviated Journal |
JAMA Surg |
| Volume |
152 |
Issue |
3 |
Pages |
251-256 |
| Keywords |
*Attitude of Health Personnel; *Developing Countries; Education, Distance; *Education, Medical; Faculty, Medical/psychology; General Surgery/*education/standards; Humans; International Educational Exchange; Internationality; Internship and Residency; Interviews as Topic; Perception; Peru; Qualitative Research; *Quality of Health Care; Surgeons/*psychology; *Traumatology |
| Abstract |
Importance: The globalization of medical education-the process by which trainees in any region gain access to international training (electronic or in-person)-is a growing trend. More data are needed to inform next steps in the responsible stewardship of this process, from the perspective of trainees and institutions at all income levels, and for use by national and international policymakers. Objective: To describe the impact of the globalization of medical education on surgical care in Peru from the perspective of Peruvian surgeons who received international training. Design, Setting, and Participants: Observational study of qualitative interviews conducted from September 2015 to January 2016 using grounded theory qualitative research methods. The study was conducted at 10 large public institutions that provide most of the trauma care in Lima, Peru, and included urban resident and faculty surgery and trauma care physicians. Exposures: Access to international surgical rotations and medical information. Main Outcomes and Measures: Outcome measures defining the impact of globalization on surgical care were developed as part of simultaneous data collection and analysis during qualitative research as part of a larger project on trauma quality improvement practices in Peru. Results: Fifty qualitative interviews of surgeons and emergency medicine physicians were conducted at 10 hospitals, including multiple from the public and social security systems. A median of 4 interviews were conducted at each hospital, and fewer than 3 interviews were conducted at only 1 hospital. From the broader theme of globalization emerged subthemes of an eroded sense of agency and a perception of inadequate training on the adaptation of international standards as negative effects of globalization on surgical care in Peru. Access to research funds, provision of incentives for acquisition of advanced clinical training, increased expectations for patient outcomes, and education in quality improvement skills are ways in which globalization positively affected surgeons and their patients in Peru. Conclusions and Relevance: Short-term overseas training of surgeons from low- and middle-income countries may improve care in the surgeons' country of origin through the acquisition of skills and altered expectations for excellence. Prioritization of evidence-based medical education is necessary given widespread internet access and thus clinician exposure to variable quality medical information. Finally, the establishment of centers of excellence in low- and middle-income countries may address the eroded sense of agency attributable to globalization and offer a local example of world-class surgical outcomes, diminishing surgeons' most frequently cited reason for emigration: access to better surgical training. |
| Address |
University of Washington, Seattle |
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English |
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2168-6254 |
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| Notes |
PMID:27893012 |
Approved |
no |
| Call Number |
ref @ user @ |
Serial |
97649 |
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| Author |
Heydari, N.; Larsen, D.A.; Neira, M.; Beltran Ayala, E.; Fernandez, P.; Adrian, J.; Rochford, R.; Stewart-Ibarra, A.M. |
| Title |
Household Dengue Prevention Interventions, Expenditures, and Barriers to Aedes aegypti Control in Machala, Ecuador |
Type |
Journal Article |
| Year |
2017 |
Publication |
International Journal of Environmental Research and Public Health |
Abbreviated Journal |
Int J Environ Res Public Health |
| Volume |
14 |
Issue |
2 |
Pages |
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| Keywords |
Aedes/*growth & development; Animals; Dengue/epidemiology/*prevention & control; Ecuador/epidemiology; Housing; Humans; Insect Vectors/*virology; Insecticides/*economics; Mosquito Control/*economics/*methods; Mosquito Nets/*economics; Socioeconomic Factors; Aedes aegypti; Ecuador; Kap; dengue fever; economic cost; mosquito control |
| Abstract |
The Aedes aegypti mosquito is an efficient vector for the transmission of Zika, chikungunya, and dengue viruses, causing major epidemics and a significant social and economic burden throughout the tropics and subtropics. The primary means of preventing these diseases is household-level mosquito control. However, relatively little is known about the economic burden of Ae. aegypti control in resource-limited communities. We surveyed residents from 40 households in a high-risk community at the urban periphery in the city of Machala, Ecuador, on dengue perceptions, vector control interventions, household expenditures, and factors influencing purchasing decisions. The results of this study show that households spend a monthly median of US$2.00, or 1.90% (range: 0.00%, 9.21%) of their family income on Ae. aegypti control interventions. Households reported employing, on average, five different mosquito control and dengue prevention interventions, including aerosols, liquid sprays, repellents, mosquito coils, and unimpregnated bed nets. We found that effectiveness and cost were the most important factors that influence people's decisions to purchase a mosquito control product. Our findings will inform the development and deployment of new Ae. aegypti control interventions by the public health and private sectors, and add to prior studies that have focused on the economic burden of dengue-like illness. |
| Address |
Center for Global Health and Translational Science, State University of New York Upstate Medical University, Syracuse, NY 13210, USA. amstew01@gmail.com |
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English |
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1660-4601 |
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PMID:28212349 |
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no |
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ref @ user @ |
Serial |
97645 |
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