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Author Del Brutto, O.H.; Mera, R.M.; Zambrano, M.; Del Brutto, V.J. url  doi
openurl 
  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  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title (up) Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 1747-4930 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:27777377 Approved no  
  Call Number ref @ user @ Serial 97655  
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Author Gragnani, A.; de Oliveira, A.F.; Boro, D.; Pham, T.N.; Ferreira, L.M. url  doi
openurl 
  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  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title (up) Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 0305-4179 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:27663506 Approved no  
  Call Number ref @ user @ Serial 97661  
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Author Rocha, G. da S.; Mello Jorge, M.H.P. de; Grembek, O. url  doi
openurl 
  Title After-effects and disabilities in traffic crash victims in northern Brazil Type Journal Article
  Year 2017 Publication Traffic Injury Prevention Abbreviated Journal Traffic Inj Prev  
  Volume 18 Issue 4 Pages 412-419  
  Keywords Accidents, Traffic/*statistics & numerical data; Adolescent; Adult; Aged; Brazil/epidemiology; Child; Cities; Cross-Sectional Studies; *Disabled Persons; Facial Injuries/epidemiology/mortality/pathology; Female; Humans; Injury Severity Score; Logistic Models; Male; Middle Aged; Motorcycles; Odds Ratio; Risk Factors; Wounds and Injuries/*epidemiology/mortality/pathology; Young Adult; Crashes; after-effects; severity of trauma; traffic; victims  
  Abstract OBJECTIVES: The objective of this study was to identify the characteristics related to crash and victim, as well as the after-effects/disabilities and consequences arising from traffic crashes occurring in the city of Rio Branco-Acre. METHODS: This is an analytical descriptive cross-sectional study conducted in the City of Rio Branco-Acre. The study population consisted of 405 residents of the city who were victims of traffic crashes, of all age groups and genders, who were hospitalized for the first time as a result of the crash in public hospitals and the health system network, as recorded in the Hospital Information System, and who were discharged between January 1 and December 31, 2010. The data sources included hospital record consultations and active searches for the victims. Hierarchical logistic regression was performed to evaluate the factors associated with the after-effects. RESULTS: The majority of the study population was motorcycle victims (68.6%), male, and young (20-39 years). Concerning the after-effects, the following were significantly associated: factors related to the presence of a postcrash activity limitation (odds ratio [OR] = 2.39; 95% confidence interval [CI], 2.39-6.76), length of hospital stay in days (OR = 1 03; 95% CI, 1.01-1.06), and surgical treatment (OR = 1.82; 95% CI, 1.03-3.21). Those who suffered damage to soft tissue and nerves or facial injury showed an odds ratio of 2 to 4 times of having an after-effect/disability, independent of the victim's personal attributes. CONCLUSION: The mechanism, such as the origin of the pattern of injuries, explains the exposure factors shown by each attribute of the victim and their characteristics. Many of the injuries were precursors to after-effects/disabilities, which, due to their nature and extent, result in the modification of the apparently healthy living standards of young victims who are routinely injured in traffic crashes. Therefore, public policies for prevention should be formulated, reformulated, and implemented, taking into account each attribute of the victims and their social conditions, because these are closely related to their habits and customs. This is a starting point for promoting changes to the current reality that traffic crashes present in the morbidity and mortality of the population.  
  Address c University of California , Berkeley , Safe Transportation Research and Education Center , Berkeley , California  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title (up) Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 1538-9588 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:27575383 Approved no  
  Call Number ref @ user @ Serial 97666  
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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 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 (up) 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 Blot, S.; Bauer, G.; Fraser, M.; Nleya, M.; Wadham, M. url  doi
openurl 
  Title AIDS Service Organization Access Among African, Caribbean and Other Black Residents of an Average Canadian City Type Journal Article
  Year 2017 Publication Journal of Immigrant and Minority Health Abbreviated Journal J Immigr Minor Health  
  Volume 19 Issue 4 Pages 851-860  
  Keywords African; Black people; Caribbean; Hiv/Aids; Health disparities; Health services research; Immigrant health; Minority health  
  Abstract Due to heightened vulnerability to HIV/AIDS, African, Caribbean and Black (ACB) communities are priority groups for prevention and intervention services in Canada. However, it is not clear which factors may affect ACB communities' access to these services. We evaluated access to the local AIDS service organization (ASO) in Middlesex-London by using data from the Black, African and Caribbean Canadian Health Study. Modified Poisson regression was used to obtain prevalence risk ratios for factors associated with three measures of access: familiarity with the ASO, willingness to access, and realized access. In adjusted analyses, older ACB community members were more likely to be familiar with the ASO, willing to access it, and have actually gone there. Canadian-born participants were less likely to have been to the ASO than recent immigrants. These results have implications for reaching specific segments of ACB communities for HIV/AIDS-related services in Canada.  
  Address Women and HIV/AIDS Initiative, Toronto, ON, Canada  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title (up) Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 1557-1912 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:26895153 Approved no  
  Call Number ref @ user @ Serial 97682  
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