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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 (up) 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 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 97458  
Permanent link to this record
 

 
Author Barros, J.; Morales, S.; Echavarri, O.; Garcia, A.; Ortega, J.; Asahi, T.; Moya, C.; Fischman, R.; Maino, M.P.; Nunez, C. url  doi
openurl 
  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 (up) 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  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 1516-4446 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:27783715 Approved no  
  Call Number ref @ user @ Serial 97654  
Permanent link to this record
 

 
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 (up) 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 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  
Permanent link to this record
 

 
Author Kane, S.P.; Hanes, S.D. url  doi
openurl 
  Title Unexplained increases in serum vancomycin concentration in a morbidly obese patient Type Journal Article
  Year 2017 Publication Intensive & Critical Care Nursing Abbreviated Journal Intensive Crit Care Nurs  
  Volume (up) 39 Issue Pages 55-58  
  Keywords Anti-Bacterial Agents/administration & dosage/therapeutic use; Cross Reactions/physiology; Drug-Related Side Effects and Adverse Reactions/*physiopathology; Female; Humans; Middle Aged; Obesity, Morbid/*drug therapy/physiopathology; Pneumonia, Ventilator-Associated/drug therapy/prevention & control; Vancomycin/*administration & dosage/therapeutic use; Central venous catheters; Critical care; Drug monitoring; Infectious disease; Medication safety; Vancomycin  
  Abstract INTRODUCTION: To report a case of increases in vancomycin concentrations without additional vancomycin doses being given. CASE STUDY: A 64 year-old morbidly obese female received three total doses of vancomycin for surgical prophylaxis and for ventilator-associated pneumonia. Subsequent vancomycin concentrations from the patient's central venous catheter (CVC) demonstrated increasing drug levels from 27.1 to 45.9mcg/mL despite no additional vancomycin being given and proper line flushing prior to sample collection. There is no clear explanation for the increase in the patient's vancomycin concentration. Drug leaching from the CVC, enterohepatic recycling, drug redistribution from adipose or other tissues, and assay cross-reactivity with other medications are all potential explanations for the increased vancomycin concentrations. CONCLUSION: This case report describes an unexplained increase in vancomycin concentrations and reinforces both the fallibility of laboratory testing and that unusual circumstances do occur. Several potential causes are hypothesised with CVC drug leaching being the most likely. Nurses and other healthcare providers with similar scenarios should consider a peripheral blood sample to rule out the potential for CVC drug leaching as a possible explanation.  
  Address Department of Pharmacy Practice, Rosalind Franklin University of Medicine and Science, North Chicago, IL, United States. Electronic address: scott.hanes@rosalindfranklin.edu  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 0964-3397 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:27899248 Approved no  
  Call Number ref @ user @ Serial 98971  
Permanent link to this record
 

 
Author Kane, S.P.; Hanes, S.D. url  doi
openurl 
  Title Unexplained increases in serum vancomycin concentration in a morbidly obese patient Type Journal Article
  Year 2017 Publication Intensive & Critical Care Nursing Abbreviated Journal Intensive Crit Care Nurs  
  Volume (up) 39 Issue Pages 55-58  
  Keywords Anti-Bacterial Agents/administration & dosage/therapeutic use; Cross Reactions/physiology; Drug-Related Side Effects and Adverse Reactions/*physiopathology; Female; Humans; Middle Aged; Obesity, Morbid/*drug therapy/physiopathology; Pneumonia, Ventilator-Associated/drug therapy/prevention & control; Vancomycin/*administration & dosage/therapeutic use; Central venous catheters; Critical care; Drug monitoring; Infectious disease; Medication safety; Vancomycin  
  Abstract INTRODUCTION: To report a case of increases in vancomycin concentrations without additional vancomycin doses being given. CASE STUDY: A 64 year-old morbidly obese female received three total doses of vancomycin for surgical prophylaxis and for ventilator-associated pneumonia. Subsequent vancomycin concentrations from the patient's central venous catheter (CVC) demonstrated increasing drug levels from 27.1 to 45.9mcg/mL despite no additional vancomycin being given and proper line flushing prior to sample collection. There is no clear explanation for the increase in the patient's vancomycin concentration. Drug leaching from the CVC, enterohepatic recycling, drug redistribution from adipose or other tissues, and assay cross-reactivity with other medications are all potential explanations for the increased vancomycin concentrations. CONCLUSION: This case report describes an unexplained increase in vancomycin concentrations and reinforces both the fallibility of laboratory testing and that unusual circumstances do occur. Several potential causes are hypothesised with CVC drug leaching being the most likely. Nurses and other healthcare providers with similar scenarios should consider a peripheral blood sample to rule out the potential for CVC drug leaching as a possible explanation.  
  Address Department of Pharmacy Practice, Rosalind Franklin University of Medicine and Science, North Chicago, IL, United States. Electronic address: scott.hanes@rosalindfranklin.edu  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 0964-3397 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:27899248 Approved no  
  Call Number ref @ user @ Serial 100001  
Permanent link to this record
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