Base de dados : MEDLINE
Pesquisa : N03.219.151.080 [Categoria DeCS]
Referências encontradas : 1979 [refinar]
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  1 / 1979 MEDLINE  
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[PMID]:28767920
[Au] Autor:Ferraz RRN; Neri ASC; Barbosa EC; Silva MVCD
[Ad] Endereço:Universidade Nove de Julho, São Paulo, SP, Brazil.
[Ti] Título:Implementing apportionment strategy to identify costs in a multidisciplinary clinic.
[So] Source:Einstein (Sao Paulo);15(2):206-211, 2017 Apr-Jun.
[Is] ISSN:2317-6385
[Cp] País de publicação:Brazil
[La] Idioma:eng; por
[Ab] Resumo:Objective: To present the implementation of an apportionment strategy proportional to the productive areas of a multidisciplinary clinic, defining the minimum values to be passed monthly to health professionals who work there. Methods: A study of the clinic structure was carried out, in which the area of occupation of each service was defined. Later the cost was prorated, allocating a value to each room, proportional to the space occupied. Results: The apportionment implementation allowed the clinic managers to visualize the cost of each room, providing a value base for formation of a minimum amount necessary to be passed monthly to each professional, as a form of payment for rent of using their facilities. Conclusion: The risk of financial loss of the clinic was minimized due to variation of its productivity, as well as the conditions of transference at the time of hiring by professionals were clear, promoting greater confidence and safety in contract relations. Objetivo: Apresentar a implantação de uma estratégia de rateio proporcional às áreas produtivas de uma clínica multidisciplinar, definindo valores mínimos a serem repassados mensalmente aos profissionais de saúde que as ocupam. Métodos: Estudo da estrutura da clínica, no qual foi definida, em metros quadrados, a área de ocupação de cada serviço. Em seguida, o custo foi rateado, alocando um valor a cada sala, proporcional ao espaço ocupado. Resultados: A implantação do rateio possibilitou aos gestores da clínica estudada visualizar o custo de cada sala, fornecendo uma base de valor para formação de um valor mínimo necessário a ser repassado mensalmente para cada profissional, como forma de pagamento pelo aluguel de utilização de suas instalações. Conclusão: Minimizou-se o risco de prejuízo da clínica pela variação de sua produtividade, bem como ficaram claras as condições de repasse no momento de contratação do aluguel pelos profissionais, promovendo maior confiança e segurança na relação contratual.
[Mh] Termos MeSH primário: Instituições de Assistência Ambulatorial/economia
Alocação de Custos/métodos
[Mh] Termos MeSH secundário: Brasil
Custos e Análise de Custo/economia
Custos e Análise de Custo/métodos
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170928
[Lr] Data última revisão:
170928
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170803
[St] Status:MEDLINE


  2 / 1979 MEDLINE  
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[PMID]:27476501
[Au] Autor:Hampshire K; Porter G; Mariwah S; Munthali A; Robson E; Owusu SA; Abane A; Milner J
[Ad] Endereço:Department of Anthropology, Durham University, Durham DH1 3LE, UK K.R.Hampshire@durham.ac.uk.
[Ti] Título:Who bears the cost of 'informal mhealth'? Health-workers' mobile phone practices and associated political-moral economies of care in Ghana and Malawi.
[So] Source:Health Policy Plan;32(1):34-42, 2017 Feb.
[Is] ISSN:1460-2237
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Africa's recent communications 'revolution' has generated optimism that using mobile phones for health (mhealth) can help bridge healthcare gaps, particularly for rural, hard-to-reach populations. However, while scale-up of mhealth pilots remains limited, health-workers across the continent possess mobile phones. This article draws on interviews from Ghana and Malawi to ask whether/how health-workers are using their phones informally and with what consequences. Health-workers were found to use personal mobile phones for a wide range of purposes: obtaining help in emergencies; communicating with patients/colleagues; facilitating community-based care, patient monitoring and medication adherence; obtaining clinical advice/information and managing logistics. However, the costs were being borne by the health-workers themselves, particularly by those at the lower echelons, in rural communities, often on minimal stipends/salaries, who are required to 'care' even at substantial personal cost. Although there is significant potential for 'informal mhealth' to improve (rural) healthcare, there is a risk that the associated moral and political economies of care will reinforce existing socioeconomic and geographic inequalities.
[Mh] Termos MeSH primário: Telefone Celular/economia
Agentes Comunitários de Saúde/economia
Telemedicina/economia
[Mh] Termos MeSH secundário: Telefone Celular/estatística & dados numéricos
Agentes Comunitários de Saúde/estatística & dados numéricos
Alocação de Custos/estatística & dados numéricos
Gana
Seres Humanos
Malaui
Serviços de Saúde Rural/economia
Serviços de Saúde Rural/estatística & dados numéricos
Telemedicina/estatística & dados numéricos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:H
[Da] Data de entrada para processamento:160802
[St] Status:MEDLINE
[do] DOI:10.1093/heapol/czw095


  3 / 1979 MEDLINE  
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[PMID]:27793480
[Au] Autor:Jiang Y; Hellegers P
[Ad] Endereço:Environmental Economics and Natural Resources Group, Wageningen University, The Netherlands. Electronic address: yu.jiang@wur.nl.
[Ti] Título:Joint pollution control in the Lake Tai Basin and the stabilities of the cost allocation schemes.
[So] Source:J Environ Manage;184(Pt 3):504-516, 2016 Dec 15.
[Is] ISSN:1095-8630
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:This paper provides insights into the allocation of benefits derived from joint wastewater treatment in the Lake Tai Basin of China and the acceptability and stability of different cost allocation schemes in a trans-jurisdictional water system context. First, the wastewater treatment cost function is estimated and coalition costs are compared to the cost of stand-alone wastewater treatment in each province. Second, two standard and five game theoretical cost allocation schemes are applied to the grand coalition. Results suggest that a cost savings of US $46.46 million can be obtained by forming a grand coalition. All allocation schemes were found to be acceptable. Results also suggest that both Shanghai and Jiangsu Province would prefer a proportional allocation scheme based on pollutant discharge, because it would offer them the largest cost savings. But this allocation scheme is the least stable one. Based on the criterion of stability, the Nash-Harsanyi scheme emerges as providing the optimal allocation. Finally, calculation of power and stability indexes suggests Jiangsu Province as an agent is critical to the success of grand coalition formation.
[Mh] Termos MeSH primário: Eliminação de Resíduos Líquidos/economia
Poluição da Água/prevenção & controle
[Mh] Termos MeSH secundário: China
Alocação de Custos
Lagos
Eliminação de Resíduos Líquidos/métodos
Águas Residuais
Poluição da Água/economia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Waste Water)
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161106
[St] Status:MEDLINE


  4 / 1979 MEDLINE  
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[PMID]:27567179
[Au] Autor:Melberg HO; Beck Olsen C; Pedersen K
[Ad] Endereço:Department of Health Management and Health Economics, University of Oslo, Box 1089, Blindern, 0317 Oslo, Norway. Electronic address: h.o.melberg@medisin.uio.no.
[Ti] Título:Did hospitals respond to changes in weights of Diagnosis Related Groups in Norway between 2006 and 2013?
[So] Source:Health Policy;120(9):992-1000, 2016 Sep.
[Is] ISSN:1872-6054
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:It has been argued that activity based payment systems make hospitals focus on the diagnostic groups that are most beneficial given costs and reimbursement rates. This article tests this hypothesis by exploring the relationship between changes in the reimbursement rates and changes in the number of registered treatment episodes for all diagnosis-related groups in Norway between 2006 and 2013. The number of treatment episodes can be affected by many factors and in order to isolate the effect of changes in the reimbursement system, we exclude DRGs affected by policy reforms and administrative changes. The results show that hospitals increased the number of admissions in a specific DRG four times more when the reimbursement was increased, relative to the change for DRGs with reduced rates. The direction of the result was consistent across time periods and sub-groups such as surgical vs. medical, and inpatient vs. outpatient DRGs. The effect was smaller, but remained significant after eliminating DRGs that were most likely to be affected by upcoding. Activities that the hospital had little control over, such as the number of births, had small effects, while activity levels in more discretionary categories, for instance mental diseases, were more affected. This demonstrates that contrary to the wishes of policy makers the economic incentives affect hospital reporting and priority setting behavior.
[Mh] Termos MeSH primário: Grupos Diagnósticos Relacionados/economia
Custos de Cuidados de Saúde
Hospitais
[Mh] Termos MeSH secundário: Alocação de Custos
Seres Humanos
Tempo de Internação/economia
Noruega
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170912
[Lr] Data última revisão:
170912
[Sb] Subgrupo de revista:H
[Da] Data de entrada para processamento:160828
[St] Status:MEDLINE


  5 / 1979 MEDLINE  
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[PMID]:27445546
[Au] Autor:Ross RM
[Ad] Endereço:Pulmonary and Critical Care Medicine, Baylor College of Medicine, Houston, TX 77030, USA.
[Ti] Título:Software for Apportionment of Asbestos-Related Mesotheliomas.
[So] Source:Can Respir J;2016:5340676, 2016.
[Is] ISSN:1916-7245
[Cp] País de publicação:Egypt
[La] Idioma:eng
[Ab] Resumo:Patients with an asbestos-related mesothelioma may be legally entitled to financial compensation. In this context, a physician may be called upon to apportion the contribution of an asbestos containing product or facility where there was asbestos exposure in the development of that individual's mesothelioma. This task is mathematically not simple. It is a complex function of each and the entire individual's above-background asbestos exposures. Factors to be considered for each of these exposures are the amount of exposure to mesotheliogenic fibers, each of the asbestos containing products' potency to cause mesothelioma, and the time period when the exposures occurred relative to when the mesothelioma was diagnosed. In this paper, the known factors related to asbestos-related mesothelioma risk are briefly reviewed and the software that is downloadable and fully functional in a Windows® environment is also provided. This software allows for rapid assessment of relative contributions and deals with the somewhat tedious mathematical calculations. With this software and a reasonable occupational history, if it is decided that the mesothelioma was due to above-background asbestos exposure, the contribution of an asbestos containing product or a time period of asbestos exposure can be apportioned.
[Mh] Termos MeSH primário: Asbestos/efeitos adversos
Exposição Ambiental/efeitos adversos
Neoplasias Pulmonares/etiologia
Mesotelioma/etiologia
Software
[Mh] Termos MeSH secundário: Animais
Asbestos/administração & dosagem
Alocação de Custos
Seres Humanos
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
1332-21-4 (Asbestos)
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160723
[St] Status:MEDLINE
[do] DOI:10.1155/2016/5340676


  6 / 1979 MEDLINE  
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[PMID]:27348945
[Au] Autor:Schwartz MJ
[Ti] Título:Out on a Limb in Dutchess County.
[So] Source:N Y State Dent J;82(3):9, 2016 Apr.
[Is] ISSN:0028-7571
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Assistência Odontológica/economia
Odontólogos
Seguro Odontológico/economia
[Mh] Termos MeSH secundário: Contratos
Alocação de Custos
Seres Humanos
Revisão da Utilização de Seguros
Cobertura do Seguro/economia
Radiografia Dentária/economia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1607
[Cu] Atualização por classe:160628
[Lr] Data última revisão:
160628
[Sb] Subgrupo de revista:D; IM
[Da] Data de entrada para processamento:160629
[St] Status:MEDLINE


  7 / 1979 MEDLINE  
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[PMID]:27338267
[Au] Autor:Wirth K; Zielinski P; Trinter T; Stahl R; Mück F; Reiser M; Wirth S
[Ad] Endereço:Institut für Klinische Radiologie, Klinikum der Universität München, Nußbaumstr. 20, 80336, München, Deutschland.
[Ti] Título:[Changing the internal cost allocation (ICA) on DRG shares : Example of computed tomography in a university radiology setting].
[Ti] Título:Umstellung der internen Leistungsverrechnung (ILV) auf DRG-Anteile : Beispiel der Computertomographie einer universitären Radiologie..
[So] Source:Radiologe;56(8):708-16, 2016 Aug.
[Is] ISSN:1432-2102
[Cp] País de publicação:Germany
[La] Idioma:ger
[Ab] Resumo:BACKGROUND: In hospitals, the radiological services provided to non-privately insured in-house patients are mostly distributed to requesting disciplines through internal cost allocation (ICA). In many institutions, computed tomography (CT) is the modality with the largest amount of allocation credits. OBJECTIVES: The aim of this work is to compare the ICA to respective DRG (Diagnosis Related Groups) shares for diagnostic CT services in a university hospital setting. MATERIALS AND METHODS: The data from four CT scanners in a large university hospital were processed for the 2012 fiscal year. For each of the 50 DRG groups with the most case-mix points, all diagnostic CT services were documented including their respective amount of GOÄ allocation credits and invoiced ICA value. As the German Institute for Reimbursement of Hospitals (InEK) database groups the radiation disciplines (radiology, nuclear medicine and radiation therapy) together and also lacks any modality differentiation, the determination of the diagnostic CT component was based on the existing institutional distribution of ICA allocations. RESULTS: Within the included 24,854 cases, 63,062,060 GOÄ-based performance credits were counted. The ICA relieved these diagnostic CT services by € 819,029 (single credit value of 1.30 Eurocent), whereas accounting by using DRG shares would have resulted in € 1,127,591 (single credit value of 1.79 Eurocent). The GOÄ single credit value is 5.62 Eurocent. CONCLUSIONS: The diagnostic CT service was basically rendered as relatively inexpensive. In addition to a better financial result, changing the current ICA to DRG shares might also mean a chance for real revenues. However, the attractiveness considerably depends on how the DRG shares are distributed to the different radiation disciplines of one institution.
[Mh] Termos MeSH primário: Centros Médicos Acadêmicos/economia
Alocação de Custos/economia
Grupos Diagnósticos Relacionados/economia
Reembolso de Seguro de Saúde/economia
Radiologia/economia
Tomografia Computadorizada por Raios X/economia
[Mh] Termos MeSH secundário: União Europeia
Alemanha
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171003
[Lr] Data última revisão:
171003
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160625
[St] Status:MEDLINE
[do] DOI:10.1007/s00117-016-0121-y


  8 / 1979 MEDLINE  
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[PMID]:27315408
[Au] Autor:López-Alonso M; Ibarrondo-Dávila MP; Rubio MC
[Ad] Endereço:Department of Construction Engineering and Engineering Projects, University of Granada, Granada, Spain.
[Ti] Título:Safety cost management in construction companies: A proposal classification.
[So] Source:Work;54(3):617-30, 2016 Jun 16.
[Is] ISSN:1875-9270
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Estimating health and safety costs in the construction industry presents various difficulties, including the complexity of cost allocation, the inadequacy of data available to managers and the absence of an accounting model designed specifically for safety cost management. Very often, the costs arising from accidents in the workplace are not fully identifiable due to the hidden costs involved. OBJECTIVE: This paper reviews some studies of occupational health and safety cost management and proposes a means of classifying these costs. METHODS: We conducted an empirical study in which the health and safety costs of 40 construction worksites are estimated. RESULTS: A new classification of the health and safety cost and its categories is proposed: Safety and non-safety costs. CONCLUSIONS: The costs of the company's health and safety policy should be included in the information provided by the accounting system, as a starting point for analysis and control. From this perspective, a classification of health and safety costs and its categories is put forward.
[Mh] Termos MeSH primário: Acidentes de Trabalho/economia
Indústria da Construção/economia
Custos e Análise de Custo/classificação
Segurança/economia
[Mh] Termos MeSH secundário: Alocação de Custos
Controle de Custos
Seres Humanos
Saúde do Trabalhador/economia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170425
[Lr] Data última revisão:
170425
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160618
[St] Status:MEDLINE
[do] DOI:10.3233/WOR-162319


  9 / 1979 MEDLINE  
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[PMID]:27088211
[Au] Autor:Shi GM; Wang JN; Zhang B; Zhang Z; Zhang YL
[Ad] Endereço:Institute of Environmental Economy and Policy, Hunan Research Academy of Environmental Science, Changsha 410006, China.
[Ti] Título:Pollution control costs of a transboundary river basin: Empirical tests of the fairness and stability of cost allocation mechanisms using game theory.
[So] Source:J Environ Manage;177:145-52, 2016 Jul 15.
[Is] ISSN:1095-8630
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:With rapid economic growth, transboundary river basin pollution in China has become a very serious problem. Based on practical experience in other countries, cooperation among regions is an economic way to control the emission of pollutants. This study develops a game theoretic simulation model to analyze the cost effectiveness of reducing water pollutant emissions in four regions of the Jialu River basin while considering the stability and fairness of four cost allocation schemes. Different schemes (the nucleolus, the weak nucleolus, the Shapley value and the Separable Cost Remaining Benefit (SCRB) principle) are used to allocate regionally agreed-upon water pollutant abatement costs. The main results show that the fully cooperative coalition yielded the highest incremental gain for regions willing to cooperate if each region agreed to negotiate by transferring part of the incremental gain obtained from the cooperation to cover the losses of other regions. In addition, these allocation schemes produce different outcomes in terms of their fairness to the players and in terms of their derived stability, as measured by the Shapley-Shubik Power Index and the Propensity to Disrupt. Although the Shapley value and the SCRB principle exhibit superior fairness and stabilization to the other methods, only the SCRB principle may maintains full cooperation among regions over the long term. The results provide clear empirical evidence that regional gain allocation may affect the sustainability of cooperation. Therefore, it is implied that not only the cost-effectiveness but also the long-term sustainability should be considered while formulating and implementing environmental policies.
[Mh] Termos MeSH primário: Alocação de Custos
Rios
Poluição da Água/economia
Poluição da Água/prevenção & controle
[Mh] Termos MeSH secundário: Análise da Demanda Biológica de Oxigênio
China
Análise Custo-Benefício
Política Ambiental
Teoria do Jogo
Indústrias
Modelos Econômicos
Modelos Teóricos
Poluição da Água/análise
Qualidade da Água
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160419
[St] Status:MEDLINE


  10 / 1979 MEDLINE  
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[PMID]:27084617
[Au] Autor:Mailhot Vega RB; Ishaq O; Raldow A; Perez CA; Jimenez R; Scherrer-Crosbie M; Bussiere M; Taghian A; Sher DJ; MacDonald SM
[Ad] Endereço:Department of Radiation Oncology, NYU School of Medicine, New York, New York.
[Ti] Título:Establishing Cost-Effective Allocation of Proton Therapy for Breast Irradiation.
[So] Source:Int J Radiat Oncol Biol Phys;95(1):11-8, 2016 May 01.
[Is] ISSN:1879-355X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Cardiac toxicity due to conventional breast radiation therapy (RT) has been extensively reported, and it affects both the life expectancy and quality of life of affected women. Given the favorable oncologic outcomes in most women irradiated for breast cancer, it is increasingly paramount to minimize treatment side effects and improve survivorship for these patients. Proton RT offers promise in limiting heart dose, but the modality is costly and access is limited. Using cost-effectiveness analysis, we provide a decision-making tool to help determine which breast cancer patients may benefit from proton RT referral. METHODS AND MATERIALS: A Markov cohort model was constructed to compare the cost-effectiveness of proton versus photon RT for breast cancer management. The model was analyzed for different strata of women based on age (40 years, 50 years, and 60 years) and the presence or lack of cardiac risk factors (CRFs). Model entrants could have 1 of 3 health states: healthy, alive with coronary heart disease (CHD), or dead. Base-case analysis assumed CHD was managed medically. No difference in tumor control was assumed between arms. Probabilistic sensitivity analysis was performed to test model robustness and the influence of including catheterization as a downstream possibility within the health state of CHD. RESULTS: Proton RT was not cost-effective in women without CRFs or a mean heart dose (MHD) <5 Gy. Base-case analysis noted cost-effectiveness for proton RT in women with ≥1 CRF at an approximate minimum MHD of 6 Gy with a willingness-to-pay threshold of $100,000/quality-adjusted life-year. For women with ≥1 CRF, probabilistic sensitivity analysis noted the preference of proton RT for an MHD ≥5 Gy with a similar willingness-to-pay threshold. CONCLUSIONS: Despite the cost of treatment, scenarios do exist whereby proton therapy is cost-effective. Referral for proton therapy may be cost-effective for patients with ≥1 CRF in cases for which photon plans are unable to achieve an MHD <5 Gy.
[Mh] Termos MeSH primário: Neoplasias da Mama/radioterapia
Coração/efeitos da radiação
Terapia com Prótons/economia
[Mh] Termos MeSH secundário: Adulto
Fatores Etários
Idoso
Cateterismo
Doença das Coronárias/complicações
Alocação de Custos/economia
Alocação de Custos/métodos
Análise Custo-Benefício
Sistemas de Apoio a Decisões Clínicas
Feminino
Seres Humanos
Expectativa de Vida
Cadeias de Markov
Meia-Idade
Modelos Econométricos
Órgãos em Risco/efeitos da radiação
Fótons/uso terapêutico
Terapia com Prótons/efeitos adversos
Qualidade de Vida
Anos de Vida Ajustados por Qualidade de Vida
Lesões por Radiação/prevenção & controle
Dosagem Radioterapêutica
Fatores de Risco
Sensibilidade e Especificidade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1609
[Cu] Atualização por classe:160416
[Lr] Data última revisão:
160416
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160417
[St] Status:MEDLINE



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