| 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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English |
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0963-8288 |
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| Notes |
PMID:26987029 |
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no |
| Call Number |
ref @ user @ |
Serial |
97680 |
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Saunders, M.J.; Wingfield, T.; Tovar, M.A.; Baldwin, M.R.; Datta, S.; Zevallos, K.; Montoya, R.; Valencia, T.R.; Friedland, J.S.; Moulton, L.H.; Gilman, R.H.; Evans, C.A. |
| Title |
A score to predict and stratify risk of tuberculosis in adult contacts of tuberculosis index cases: a prospective derivation and external validation cohort study |
Type |
Journal Article |
| Year |
2017 |
Publication |
The Lancet. Infectious Diseases |
Abbreviated Journal |
Lancet Infect Dis |
| Volume |
17 |
Issue |
11 |
Pages |
1190-1199 |
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| Abstract |
BACKGROUND: Contacts of tuberculosis index cases are at increased risk of developing tuberculosis. Screening, preventive therapy, and surveillance for tuberculosis are underused interventions in contacts, particularly adults. We developed a score to predict risk of tuberculosis in adult contacts of tuberculosis index cases. METHODS: In 2002-06, we recruited contacts aged 15 years or older of index cases with pulmonary tuberculosis who lived in desert shanty towns in Ventanilla, Peru. We followed up contacts for tuberculosis until February, 2016. We used a Cox proportional hazards model to identify index case, contact, and household risk factors for tuberculosis from which to derive a score and classify contacts as low, medium, or high risk. We validated the score in an urban community recruited in Callao, Peru, in 2014-15. FINDINGS: In the derivation cohort, we identified 2017 contacts of 715 index cases, and median follow-up was 10.7 years (IQR 9.5-11.8). 178 (9%) of 2017 contacts developed tuberculosis during 19 147 person-years of follow-up (incidence 0.93 per 100 person-years, 95% CI 0.80-1.08). Risk factors for tuberculosis were body-mass index, previous tuberculosis, age, sustained exposure to the index case, the index case being in a male patient, lower community household socioeconomic position, indoor air pollution, previous tuberculosis among household members, and living in a household with a low number of windows per room. The 10-year risks of tuberculosis in the low-risk, medium-risk, and high-risk groups were, respectively, 2.8% (95% CI 1.7-4.4), 6.2% (4.8-8.1), and 20.6% (17.3-24.4). The 535 (27%) contacts classified as high risk accounted for 60% of the tuberculosis identified during follow-up. The score predicted tuberculosis independently of tuberculin skin test and index-case drug sensitivity results. In the external validation cohort, 65 (3%) of 1910 contacts developed tuberculosis during 3771 person-years of follow-up (incidence 1.7 per 100 person-years, 95% CI 1.4-2.2). The 2.5-year risks of tuberculosis in the low-risk, medium-risk, and high-risk groups were, respectively, 1.4% (95% CI 0.7-2.8), 3.9% (2.5-5.9), and 8.6%. (5.9-12.6). INTERPRETATION: Our externally validated risk score could predict and stratify 10-year risk of developing tuberculosis in adult contacts, and could be used to prioritise tuberculosis control interventions for people most likely to benefit. FUNDING: Wellcome Trust, Department for International Development Civil Society Challenge Fund, Joint Global Health Trials consortium, Bill & Melinda Gates Foundation, Imperial College National Institutes of Health Research Biomedical Research Centre, Foundation for Innovative New Diagnostics, Sir Halley Stewart Trust, WHO, TB REACH, and Innovation for Health and Development. |
| Address |
Section of Infectious Diseases and Immunity, Imperial College London, London, UK; Wellcome Trust Imperial College Centre for Global Health Research, London, UK; Innovation for Health and Development (IFHAD), Laboratory of Research and Development, Universidad Peruana Cayetano Heredia, Lima, Peru; Innovacion Por la Salud Y Desarrollo (IPSYD), Asociacion Benefica PRISMA, Lima, Peru |
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1473-3099 |
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| Notes |
PMID:28827142 |
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no |
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ref @ user @ |
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97505 |
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Castillo, M.E.; Molina, J.R.; Rodriguez Y Silva, F.; Garcia-Chevesich, P.; Garfias, R. |
| Title |
A system to evaluate fire impacts from simulated fire behavior in Mediterranean areas of Central Chile |
Type |
Journal Article |
| Year |
2017 |
Publication |
The Science of the Total Environment |
Abbreviated Journal |
Sci Total Environ |
| Volume |
579 |
Issue |
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Pages |
1410-1418 |
| Keywords |
Wildfire behavior; Wildfire intensity; Wildfire simulation |
| Abstract |
Wildfires constitute the greatest economic disruption to Mediterranean ecosystems, from a socio-economic and ecological perspective (Molina et al., 2014). This study proposes to classify fire intensity levels based on potential fire behavior in different types of Mediterranean vegetation types, using two geographical scales. The study considered >4 thousand wildfires over a period of 25years, identifying fire behavior on each event, based on simulations using “KITRAL”, a model developed in Chile in 1993 and currently used in the entire country. Fire intensity values allowed results to be classified into six fire effects categories (levels), each of them with field indicators linking energy values with damage related to burned vegetation and wildland urban interface zone. These indicators also facilitated a preliminary assessment of wildfire impact on different Mediterranean land uses and, are therefore, a useful tool to prioritize future interventions. |
| Address |
International Hydrology Research Group, Faculty of Forest Sciences and Nature Conservancy, University of Chile |
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0048-9697 |
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PMID:27923572 |
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no |
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ref @ user @ |
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97511 |
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Kim, M.Y.; Park, S.-J.; Shim, J.W.; Song, Y.J.; Yang, K.; Park, S.-J.; Heo, K. |
| Title |
Accumulation of low-dose BIX01294 promotes metastatic potential of U251 glioblastoma cells |
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Journal Article |
| Year |
2017 |
Publication |
Oncology Letters |
Abbreviated Journal |
Oncol Lett |
| Volume |
13 |
Issue |
3 |
Pages |
1767-1774 |
| Keywords |
Bix01294; epithelial-mesenchymal transition; glioblastoma stem cells; metastasis |
| Abstract |
BIX01294 (Bix) is known to be a euchromatic histone-lysine N-methyltransferase 2 inhibitor and treatment with Bix suppresses cancer cell survival and proliferation. In the present study, it was observed that sequential treatment with low-dose Bix notably increases glioblastoma cell migration and metastasis. It was demonstrated that U251 cells sequentially treated with low-dose Bix exhibited induced characteristic changes in critical epithelial-mesenchymal transition (EMT) markers, including E-cadherin, N-cadherin, beta-catenin and zinc finger protein SNAI2. Notably, sequential treatment with Bix also increased the expression of cancer stem cell-associated markers, including sex determining region Y-box 2, octamer-binding transcription factor 4 and cluster of differentiation 133. Neurosphere formation was significantly enhanced in cells sequentially treated with Bix, compared with control cells (control: P=0.011; single treatment of Bix, P=0.045). The results of the present study suggest that accumulation of low-dose Bix enhanced the migration and metastatic potential of glioblastoma cells by regulating EMT-associated gene expression, which may be the cause of the altered properties of glioblastoma stem cells. |
| Address |
Research Center, Dongnam Institute of Radiological and Medical Science (DIRAMS), Busan 619-953, Republic of Korea |
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1792-1074 |
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PMID:28454322 |
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no |
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ref @ user @ |
Serial |
96588 |
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Rocha, G. da S.; Mello Jorge, M.H.P. de; Grembek, O. |
| 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 |
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1538-9588 |
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PMID:27575383 |
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no |
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ref @ user @ |
Serial |
97666 |
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