Avaliação da qualidade da assistência aos portadores de úlceras venosas atendidos no ambulatório de um hospital universitário em Natal/RN

Study descriptive that was designed to assess the quality of care for people with venous ulcers (VUs) tended at the ambulatory of a university hospital in Natal / RN. The target population of the study was composed by 40 users bearers of venous ulcers served in the ambulatory of angiology of a university hospital in the level of tertiary education. The study received assent of the Ethics Committee of the Federal University of Rio Grande do Norte (Protocol No. 169/06). The collect of data was performed using a form of interview and tour with collection of measures biophysiologic, for a team comprised by the researchers and an academic of nursing, in the period of three months. The data were analyzed in SPSS 14.0, using descriptive statistics and presented in the form of charts, tables and graphs. Identified a clientele of holders of VUs predominantly female, married, aged up to 59 years, low level of education and household income, from Natal, retirees or those exercising professions and occupations that require long periods standing or sitting. In relation to the characteristics of health, those surveyed had risk factors for venous disease and had UVs chronic, located in Zone 2, lost tissue in grade II and serous exudates on average quantity. The assistance to holders of UVs has been characterized by a lack of professional nurses and unavailability of products for the realization of the right curative in ambulatory and outside it; by the inadequacy of products used in VUs, for long periods of treatment without resolution, where the compressive therapy is not priority, by the lack of completeness in the levels of assistance; by monitoring the bearer of UVs only by doctors and the nurses, even with the other team of professionals in the health service; by the completion of guidelines by health professionals and the lack the standardization of conducting laboratory and specifics tests. The assistance was assessed as inadequate in aspects: reference and counter-reference (75.0%), number of consultations with angiologists last year (87.5%), documentation of the clinical findings (85.0%), use of compressive therapy in the past 30 days (77.5%), part of the team interdisciplinary (97.5%), completion of laboratory and specifics tests in the last year (100%), availability of products used in achieving the curative in ambulatory (80, 0%), and indication of products used in the conduct of dressing outside the clinic (70.0%) and appropriate in the guidelines made on the use of socks, lifting of the members and prescription of exercises regular (82.5%) and indication products used in achieving the curative in ambulatory (97.5%). We conclude that the assistance provided to holders of UV was inadequate in 80% of cases interviewed, becoming non-resolutive and assistematic

Qualidade de vida de pessoas com úlceras venosas atendidos no ambulatório de um hospital universitário

Descriptive study aimed to analyze the quality of life (QOL) of patients with venous ulcers (UV) outpatient clinic of a university hospital in Natal / RN. The aim of the study population was composed of 50 patients with UV treated at the cardiology clinic of a university teaching hospital at the tertiary level. The study was approved by the Ethics Committee of the Federal University of Rio Grande do Norte (Protocol 279/09). Data collection was performed over a period of two months by the very a masters degree and an academic nursing through the application of a form concerning the socio-demographic, clinical, and health care, and the instruments WHOQOL and WHOQOL - old. The data were analyzed with SPSS 15.0, using descriptive and inferential statistics presented in the form of tables, charts and graphs. Of the surveyed, female predominance, age range 59 years, Catholic, low education, married, with up to 03 children, not working, retired, or with occupations requiring long periods in one position, wage income of up to 02 minimum wages, inadequate sleep, patients with chronic venous insufficiency and other chronic diseases such as diabetes and hypertension, were taking medications for treatment, being a minority to IVC. In patients with predominant only one injury, time of injury up to five years, inadequate rest, pain, edema and lesions colonized. The assistance the UV patients began treatment of the injury until four months after the onset of the ulcer, and services primary health care most wanted, access to angiologist by reference form, commuted by public transportation, received support regarding the treatment of injuries. The topical product most used in the lesion was healing, and few were using compression therapy. respondents suffer discrimination in society, showed changes in quality of life after the occurrence of ulcer in relation to leisure, pain, restriction of social / school / transportation; barring employment / financial / social ladder; Physical appearance / discrimination and restriction of domestic activity. These changes were related to the time of injury and found that the more chronic injury is the most negative changes occur in their QV (ρ = 0.000). Analyzing the characteristics of QV measured by the WHOQOL-bref, we found for the two general questions they are dissatisfied with their health (ρ = 0.023) and all areas have significant difference compared with the worst QV have the injury of more than 5 years (ρ = 0.000). The QV measured by the WHOQOL-old, we found that these patients had no changes from the time of injury. We conclude that the QV of patients with UV was considered unsatisfactory when compared to the time of injury on more than 5 years which shows that the quality of life worsens with time the chronic UV.

Influência dos modelos digitais de terreno na modelagem de circulação hidrodinâmica 2DH: um estudo de caso

Digital Elevation Models (DEM) are numerical representations of a portion of the earth surface. Among several factors which affect the quality of a DEM, it should be emphasized the attention on the input data and the choice of the interpolating algorithm. On the other hand, several numerical models are used nowadays to characterize nearshore hydrodynamics and morphological changes in coastal areas, whose validation is based on field data collection. Independent on the complexity of the physical processes which are modeled, little attention has been given to the intrinsic bathymetric interpolation built within the numerical models of the specific application. Therefore, this study aims to investigate and to quantify the influence of the bathymetry, as obtained by a DEM, on the hydrodynamic circulation model at a coastal stretch, off the coast of the State of Rio Grande do Norte, Northeast Brazil. This coastal region is characterized by strong hydrodynamic and littoral processes, resulting in a very dynamic morphology with shallow coastal bathymetry. Important economic activities, such as oil exploitation and production, fisheries, salt ponds, shrimp farms and tourism, also bring impacts upon the local ecosystems and influence themselves the local hydrodynamics. This fact makes the region one of the most important for the development of the State, but also enhances the possibility of serious environmental accidents. As a hydrodynamic model, SisBaHiA® - Environmental Hydrodynamics System ( Sistema Básico de Hidrodinâmica Ambiental ) was chosen, for it has been successfully employed at several locations along the Brazilian coast. This model was developed at the Coastal and Oceanographical Engineering Group of the Ocean Engineering Program at the Federal University of Rio de Janeiro. Several interpolating methods were tested for the construction of the DEM, namely Natural Neighbor, Kriging, Triangulation with Linear Interpolation, Inverse Distance to a Power, Nearest Neighbor, and Minimum Curvature, all implemented within the software Surfer®. The bathymetry which was used as reference for the DEM was obtained from nautical charts provided by the Brazilian Hydrographic Service of the Brazilian Navy and from a field survey conducted in 2005. Changes in flow velocity and free surface elevation were evaluated under three aspects: a spatial vision along three profiles perpendicular to the coast and one profile longitudinal to the coast as shown; a temporal vision from three central nodes of the grid during 30 days; a hodograph analysis of components of speed in U and V, by different tidal cycles. Small, but negligible, variations in sea surface elevation were identified. However, the differences in flow and direction of velocities were significant, depending on the DEM