Effect of cooling rate on properties of plasma nitrided AISI 1010 steel

In this work, AISI 1010 steel samples were plasma nitrided into 20% N 2 100 Pa and 400 Pa for N 2 and H 2 , respectively), temperatures of 500 and 580 °C, during 2 h. Three different procedures for cooling were accomplished after nitriding. In the first procedure the cooling occurred naturally, that is, the sample was kept on substrate holder. In the second one the sample was pulled off and cooling in a cold surface. Finally, in the third cooling process the sample was pulled off the substrate holder down into special reservoir filled with oil held at ambient temperature. The properties of the AISI 1010 steel samples were characterized by optical and electron microscopy, X-ray diffraction, Mössbauer spectroscopy and microhardness tests. Thermal gradient inside the sample kept on substrate holder during cooling process was measured by three inserted thermocouples at different depths. When samples were cooled rapidly the transformation of ϵ-Fe 2 − 3 N to γ′-Fe 4 N was inhibited. Such effect is indicated by the high concentration of ϵ-Fe compound zone. To get solid state solution of nitrogen in the diffusion zone, instead of precipitates of nitride phases, the cooling rate should be higher than a critical value of about 0.95 °C/s. When this value is reached at any depth of the diffusion zone, two distinct diffusion zones will appear. Temperature gradients were measured inside the samples as a consequence of the plasma treatment. It's suggested the need for standardization of the term “treatment temperature” for plasma treatment because different nitrided layer properties could be reported for the same “treatment temperature”.

Effect of cooling rate on properties of plasma nitrided AISI 1010 steel

In this work, AISI 1010 steel samples were plasma nitrided into 20% N 2 100 Pa and 400 Pa for N 2 and H 2 , respectively), temperatures of 500 and 580 °C, during 2 h. Three different procedures for cooling were accomplished after nitriding. In the first procedure the cooling occurred naturally, that is, the sample was kept on substrate holder. In the second one the sample was pulled off and cooling in a cold surface. Finally, in the third cooling process the sample was pulled off the substrate holder down into special reservoir filled with oil held at ambient temperature. The properties of the AISI 1010 steel samples were characterized by optical and electron microscopy, X-ray diffraction, Mössbauer spectroscopy and microhardness tests. Thermal gradient inside the sample kept on substrate holder during cooling process was measured by three inserted thermocouples at different depths. When samples were cooled rapidly the transformation of ϵ-Fe 2 − 3 N to γ′-Fe 4 N was inhibited. Such effect is indicated by the high concentration of ϵ-Fe compound zone. To get solid state solution of nitrogen in the diffusion zone, instead of precipitates of nitride phases, the cooling rate should be higher than a critical value of about 0.95 °C/s. When this value is reached at any depth of the diffusion zone, two distinct diffusion zones will appear. Temperature gradients were measured inside the samples as a consequence of the plasma treatment. It's suggested the need for standardization of the term “treatment temperature” for plasma treatment because different nitrided layer properties could be reported for the same “treatment temperature”.

Prevenção de úlceras por pressão segundo a perspectiva do enfermeiro intensivista

Analisar a atuação dos enfermeiros de unidade de terapia intensiva na prevenção da úlcera por pressão. Método: trata-se de estudo descritivo desenvolvido com 13 enfermeiros da unidade de terapia intensiva do Hospital Universitário Onofre Lopes (HUOL), em Natal-RN. Foi aplicado um questionário, submetido à análise de conteúdo temática. O estudo foi aprovado pelo Comitê de Ética da Universidade Federal do Rio Grande do Norte (UFRN), sob o CAAE n. 0240.0.051.000-10. Resultados: os enfermeiros reportaram a realização da mudança de decúbito, a avaliação de risco, a discussão com os colegas sobre as medidas adotadas, a higiene e hidratação da pele do paciente através de uso de ácidos graxos essenciais e hidratante corporal, o cuidado com a disposição dos lençóis, de forma a evitar dobras, a utilização de colchão de ar e a aplicação de placas de hidrocoloide nas proeminências ósseas. Conclusão: a prática da prevenção das úlceras por pressão aplicada pelos enfermeiros da unidade de terapia intensiva ocorre sem padronização dos cuidados

Relações de cooperação em consórcios públicos de regiões metropolitanas: análises do CONDIAM/PB e consórcio grande Recife

With the disorganized decentralization occurred in Brazil after the 1988 Constitution, municipalities have risen to the level of federal entities. This phenomenon became known as "municipalism" also brought some negative effects such as low capacity financial, economic and political of these entities. In the face of this reality , the municipalities sought in models of collaborative features to address public policy issues ultrarregionais, one of these models are the Public Consortia. Characterized as the organization of all federal entities that aim to solve public policy implementation alone that they could not, or spend great resources for such. This reality of the municipalities have an aggravating factor when looking at the situation in Metropolitan Regions (MRs). This is because the RMs has a historical process of formation that does not encourage cooperation, since that were created top-down during the military regime. Furthermore, the metropolitan municipalities have significant power asymmetries, localist vision, rigidity earmarked revenues, different scenarios conurbation, difficulty standardization of concepts and others that contribute to the vision of low cooperation of these metropolitan areas. Thus, the problem of this work is in the presence of collaborative arrangements, such as the Public Consortia in metropolitan areas, which are seen as areas of low cooperation. To elucidate this research was used for analysis the cases of CONDIAM/PB and Consórcio Grande Recife/PE, because they are apparently antagonistic, but with some points of similarity. The cases has as foundation the Theory of Common Resources, which provides the possibility of collective action through the initiative of individuals. This theory has as its methodology for analyzing the picture IAD Framework, which proposes its analysis based on three axes: external variables, the arena of action and results. The nature of the method of this research was classified as exploratory and descriptive. For the stage of date analysis, was used the method of document analysis and content, Further than of separation of the cases according to theur especificities. At the end of the study, noted that the CONDIAM/PB was a strategy of municipal government of Joao Pessoa to attract funds from the Federal Government for the purpose of to build a landfill, and over the years the ideology of cooperation was left aside, the prevailing view localist municipalities. In the case of Consórcio Grande Recife/PE, members act with some degree of cooperation, especially the collaborative aspect of the region, however, still prevails with greater strength the power of the state of Pernambuco in the decisions and paths of the consortium. Thus, was conclude that the Public Consortia analyzed are an experience of collaborative arrangement, from the initiative of members, as the theory of common resources says, but has not actually signed as a practice of collective action to overcome the dilemmas faced by metropolitan areas

Análise da estabilidade genética de células-tronco mesenquimais humanas

Human multipotent mesenchymal stromal cells (MSCs), also known as mesenchymal stem cells, have become an important and attractive therapeutic tool since they are easily isolated and cultured, have in vitro expansion potential, substantial plasticity and secrete bioactive molecules that exert trophic effects. The human umbilical cord as a cell source for cell therapy will help to avoid several ethical, political, religious and technical issues. One of the main issues with SC lines from different sources, mainly those of embryonic origin, is the possibility of chromosomal alterations and genomic instability during in vitro expansion. Cells isolated from one umbilical cord exhibited a rare balanced paracentric inversion, likely a cytogenetic constitutional alteration, karyotype: 46,XY,inv(3)(p13p25~26). Important genes related to cancer predisposition and others involved in DNA repair are located in 3p25~26. Titanium is an excellent biomaterial for bone-implant integration; however, the use can result in the generation of particulate debris that can accumulate in the tissues adjacent to the prosthesis, in the local bone marrow, in the lymph nodes, liver and spleen. Subsequently may elicit important biological responses that aren´t well studied. In this work, we have studied the genetic stability of MSC isolated from the umbilical cord vein during in vitro expansion, after the cryopreservation, and under different concentrations and time of exposition to titanium microparticles. Cells were isolated, in vitro expanded, demonstrated capacity for osteogenic, adipogenic and chondrogenic differentiation and were evaluated using flow cytometry, so they met the minimum requirements for characterization as MSCs. The cells were expanded under different concentrations and time of exposition to titanium microparticles. The genetic stability of MSCs was assessed by cytogenetic analysis, fluorescence in situ hybridization (FISH) and analysis of micronucleus and other nuclear alterations (CBMN). The cells were able to internalize the titanium microparticles, but MSCs preserve their morphology, differentiation capacity and surface marker expression profiles. Furthermore, there was an increase in the genomic instability after long time of in vitro expansion, and this instability was greater when cells were exposed to high doses of titanium microparticles that induced oxidative stress. It is necessary always assess the risks/ benefits of using titanium in tissue therapy involving MSCs, considering the biosafety of the use of bone regeneration using titanium and MSCs. Even without using titanium, it is important that the therapeutic use of such cells is based on analyzes that ensure quality, security and cellular stability, with the standardization of quality control programs appropriate. In conclusion, it is suggested that cytogenetic analysis, FISH analysis and the micronucleus and other nuclear alterations are carried out in CTMH before implanting in a patient

Ecogenômica de archaea e monitoramento de comunidades de procariotos redutores de sulfato: aplicações na indústria de petróleo e gás

The human activities responsible for the ambient degradation in the modern world are diverse. The industrial activities are preponderant in the question of the impact consequences for brazilian ecosystems. Amongst the human activities, the petroliferous industry in operation in Potiguar Petroliferous Basin (PPB) displays the constant risk of ambient impacts in the integrant cities, not only for the human populations and the environment, but also it reaches the native microorganisms of Caatinga ground and in the mangrove sediment. Not hindering, the elaboration of strategies of bioremediation for impacted areas pass through the knowledge of microbiota and its relations with the environment. Moreover, in the microorganism groups associated to oil, are emphasized the sulfate-reducing prokaryotes (SRP) that, in its anaerobic metabolism, these organisms participate of the sulfate reduction, discharging H2S, causing ambient risks and causing the corrosion of surfaces, as pipelines and tanks, resulting in damages for the industry. Some ancestries of PRS integrate the Archaea domain, group of microorganisms whose sequenced genomes present predominance of extremophilic adaptations, including surrounding with oil presence. This work has two correlated objectives: i) the detection and monitoring of the gene dsrB, gift in sulfate-reducing prokaryotes, through DGGE analysis in samples of mDNA of a mangrove sediment and semiarid soil, both in the BPP; ii) to relate genomic characteristics to the ecological aspects of Archaea through in silico studies, standing out the importance to the oil and gas industry. The results of the first work suggest that the petrodegraders communities of SRP persist after the contamination with oil in mangrove sediment and in semiarid soil. Comparing the populations of both sites, it reveals that there are variations in the size and composition during one year of experiments. In the second work, functional and structural factors are the probable cause to the pressure in maintenance of the conservation of the sequences in the multiple copies of the 16S rDNA gene. Is verified also the discrepancy established between total content GC and content GC of the same gene. Such results relating ribosomal genes and the ambient factors are important for metagenomic evaluations using PCR-DGGE. The knowledge of microbiota associated to the oil can contribute for a better destination of resources by the petroliferous industry and the development of bioremediation strategies. Likewise, search to lead to the best agreement of the performance of native microbiota in biogeochemical cycles in Potiguar Petroliferous Basin ecosystem

Frequência da infecção por Toxoplasma gondii em galinhas caipira e frangos de corte em regiões dos Estados do Rio Grande do Norte e Paraíba

Toxoplasmosis is a zoonosis caused by Toxoplasma gondii, a protozoan that has a cosmopolitan geographic distribution and low host specificity. Usually a benign and selflimiting, infection can manifest itself in a severe systemic becoming overwhelming in fetuses and patients with immunosuppression. Domestic fowl are considered one of the most important hosts in the epidemiology of toxoplasmosis, since they are potential sources of infection for humans, in addition to playing the role of important indicators of environmental contamination by oocysts of T. gondii. We studied the prevalence of infection by the protozoan in chickens of different breeding systems mesoregions from the states of Rio Grande do Norte and Paraiba: broilers from commercial farms (200/PB) and free-range chickens of small farms (322/RN and PB). Were standardized IFAT and ELISA techniques for detecting specific antibodies in blood samples of birds, and commercial kit was used to determine the prevalence by IHAT. There was no seropositive reaction by T. gondii in the samples of broilers tested, indicating that the particularities of intensive management limit the chances of infection for these animals. Among the hens, the frequency of IgG anti-T. gondii diagnosed by the techniques of IHAT, IFAT and ELISA, respectively, were 3.73% (12/322), 37.88% (122/322) and 40.37% (130/322), for both young and adult animals. Amongst the seropositive samples by IFAT, 33 (27.05%) were positive at a dilution of 1:16, in 1:32, 31 (25.41%), in 1:64, 24 (19.67%), 15 (12.29%) in 1:128, and 19 presented titer greater than or equal to 1:256 (15.57%). The evaluation of the presence of anti-T. gondii should be careful, and reagents IHAT provided erratic results in this measure for the specie studied. This suggests the need for own standardization of the kit before the use in epidemiological studies in animal species. On the other hand, substantial agreement observed between IFAT and ELISA techniques (Kappa = 0.62) enables these methods as effective methodologies for the diagnosis of toxoplasmosis in chickens. The high prevalence of specific antibodies among poultry in the region studied attempts to the potential risk of transmission of toxoplasmosis to humans

Alcoolemia em vítimas fatais de acidentes de trânsito no Rio Grande do Norte empregando cromatografia em fase gasosa - head space

Alcohol is one of the few psychotropic drugs that their consumption has admitted legally and sometimes encouraged by the society. Studies show alcohol as the highest consumption of drugs among young people and society in general, probably because of its availability and easy access. The abuse causes public health problems, which was closely related to the violence, socioeconomic problems and the high number of automobile accidents. Transit is one of the main sectors affected by the effects of alcohol, observing a high incidence in the studies. About half of automobile accidents occurs after the consumption of alcoholic beverage, and the vast majority of cases related to high concentrations of alcohol in the bloodstream. The relationship of drunk with traffic accidents is in fact evident everywhere in the world, including Brazil, where studies have shown a high relationship between alcohol consumption and traffic accidents. This study determined the alcohol in fatal victims of traffic accidents in the state of Rio Grande do Norte and established the profile of this population compared with those found in Brazil and other countries. Samples of blood of ethanol added to fulfillment of the standardization of chromatographic conditions and procedures for the analysis, being employed in the determination of alcohol in blood samples of 277 victims of traffic accidents, collected at the Institute of Scientific Technical Police of Rio Grande do North (ITEP) in the year 2007. The blood alcohol level was determined in these samples correlated with the sex, age and marital status of the victim and the location, day of week and month when the accident occurred, is doing a statistical analysis and outlining a profile of the victims of an accident at transit in the state of Rio Grande do Norte. The parameters of standardization studied ensured the quality of the analytical method and, consequently, to obtain reliable laboratory results. Being given the best temperature for injector (150 ºC), detector (250 ºC) and column (50 ºC) with a flow of gas in the column of 2mL/minutos and analysis of time of 12 minutes. The method was linear in the range of 0.01 to 3.2 g / L (r2 = 0.9989) with average recovery of 100.2% and precision with coefficient of variation less than 15%. The analysis carried out on victims of fatal road traffic accidents, ethanol detected in the blood in 66.43% of the victims and these, 96% showed concentration ≥ 0.2 g / L, 87.73% of victims were male, while 12.27% female. The younger age group (1535 years) was the most involved (52,35%) and most single (55.60%). The accidents occurred with greater prevalence in the day on Monday (27%) followed by Sunday (24,19%) and Saturday (15,52%) and it was found that the prevalence of injuries varied between the different months of the year, and in February (14.4%) and April (10.47%) the months that had a higher number of accidents, however this oscillation showed no statistically significant difference. Also no significant difference was observed between the tracks of concentration found in men and women. The standardized method showed to be efficient, given satisfactorily to the goals of this work, and the high levels of alcohol found in victims of fatal road traffic accidents are consistent with several studies of literature, and the profile of the victim also supported by presenting in its most young adults, male and single

Avaliação dos marcadores celulares por citometria de fluxo nos portadores de leucemia mieloide aguda atendidos no Hemocentro do Rio Grande do Norte-Hemonorte

The acute myeloid leukemia (AML) is a disease in which malignant myeloblasts expand, build up and suppress normal hematopoietic activity would represent a major diagnostic challenge. With the advent of immunophenotyping by flow cytometry, the diagnosis of these tumors have become more faithful, facilitating the treatment and monitoring of patients. The objectives of this study: diagnosis and classification of AML based on immunophenotyping by flow cytometry with a panel of AcMo specific for acute leukemias, set the frequency of AML in samples from patients with acute leukemias sent to the Department of Hematology Blood Center of Rio Grande do Norte - HEMONORTE, establish standards of antigen expression for different subtypes of acute leukemia and its correlation with the newly diagnosed cases refractory to treatment and recurrence of the disease, standardization of methods for detection and labeling of surface antigens by flow cytometry and intracytoplasmic flow, and observe the frequency of acute leukemia with aberrant phenotypes rare. During the study, 351 were diagnosed acute leukemia, and 179 (51%) classified as AML and 172 (49%) and ALL, which were excluded from the present work. Of the 179 AML, 92 (51.4%) were female and 87 (48.6%) were male, with ages ranging from 3 to 95 years of ag, with higher incidence in individuals in the age group of 41 to 65. Splenomegaly was the clinical finding more present, a total of 147 cases (82.1%), followed by hepatomegaly present in 132 cases (73.7%). The hemorrhagic events were observed in 55 cases (30.7%). Lymphadenopathy in turn was detected in 20 of 179 cases (11.2%). In order to classify subtypes of AML, we used a large panel of monoclonal antibodies, obtaining the following results: AML M0, 02 (1.1%) AML M1, 40 (22.3) AML M2, 60 (33.5) AML M3, 22 (12.3%) AML M4, 10 (5.6) AML M5, 13 (7.3%) AML M6 06 (3.4%) and AML M7 01 (0.6%). We observed some cases with aberrant expression of some antigens such as CD7, CD4, CD19, CD3, CD5 and TdT, CD 7 was present in 30 (16.8%), CD4 in 5 (2.8%), the CD 3 in 5 (2.8%), the CD19 in 3 (1.7%), the CD5 in 3 (1.7%) and TDT was in 7 (3.9%) cases of AML .the CD8 and CD79a was present in only a 1 case.

Obtenção de insumo farmacêutico a partir das folhas de Cissampelos sympodialis Eichl e seu efeito sobre mediadores inflamatórios relevantes para a asma

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Vocabulário técnico e formação dos profissionais da área têxtil: necessidade, elaboração e avaliação de um dicionário de terminologia do vestuário

This research work deals with the compilation of a dictionary on clothing terminology intended to be used as a pedagogic tool as part of the teaching and learning process in the Textile Engineering Course at the Federal University of Rio Grande do Norte. The main terms were selected and assessed by a team of textile teachers and students with the objective to be structured as a conceptual body of information on the following sub-areas of clothing terminology: materials (fabrics and trimmings) and products (garments). This research comprises three main steps: (a) characterization and understanding of the technical vocabulary in the clothing area as well as the identification of a pedagogic demand for a dictionary on clothing terminology, clearly expressed by the textile lecturers and students involved in the assessment of the need and validation of this project development; (b) a proposal for a specific methodology for the compilation of the dictionary which could help the communication process in the lecturing of clothing terminology and (c) based on the terminological principles and the technique of focal groups the dictionary was assessed. The technique of focal groups was used in the first step. In the second step the technique used was that of the terminological methodology adapted to the teaching approach in the Textile Course. In the third step the technique of focal groups was again utilized. It was observed that the main concern of lecturers and students is the lack of a standardized vocabulary, which renders difficult the communication process in both the teaching and learning activities as well as the professional ones in the textile industries. Various aspects, which can overlap, cause this lack of standardization. The main ones pointed out by the study team in the focal groups are: usage of regional words or expressions, usage of foreign words or expressions, analogies, and the low level of formal education, mainly among the industry workers. Another aspect to be considered is the lack of textile literature written in the Portuguese language of Brazil. This evidence shows the importance of a clothing terminology dictionary which will benefit both the education and professional activties in this field of knowledge. This dictionary will also give a substantial contribution to terminological standardization in our research field. With view to fulfill this demand, a dictionary of clothing terminology was compiled with 760 main entries, according to the modern practice in terminology with the necessary modifications concerning our needs. The result of the dictionary assessment was very assertive regarding its structure, contents and possible use in various contexts. The team work emphasized their contribution to the standardization process of the terms that proved to be one of the most important and difficult aspects of this researh work. The significance of this structured terminological dictionary was confirmed by the focal group participants relating to its use for teaching and learning activities, as a reference book, as a source of technical information and also as a tool for pedagogic studies and planning, as well as a significant collaboration to the pedagogic practices in the textile engineering course at University or any other educational institution. Besides, this dictionary can also be used to supply information within the textile field. We are aware that the present work will not exhaust the objectives of this research due to its limitations in opposition to the vast complexity demanded by the compilation of a complete work including all the areas and sub-areas of textile engineering. However, it is an important source for dissemination of concepts on the field of clothing terminology and a tool to effective standardization of the terms used in this subject field

A dança dos monstros: corpo e estética na arte e na Educação Física

The speeches about the body in interface with the technology, that fulfill the contemporary discussions, have been a stage of innumerable ethical, epistemological, aesthetic and ontological reflections. These happened bodies of the biotechnological scene also invade the dance, making several possible dialogues, making old concepts instable, opening way to revealing explorations and bringing with it implications and reflections. In this context, this research has as objective to discuss relations between body and technology in the dance; to understand the aesthetic configurations of the monster in the dance as possibility to question the body; to establish relations between the monstrous body in the dance and the conceptions of body in the Physical Education. We believe to be able to contribute for the reflection in the field of the Physical Education, since the work visualizes to extend the field of the discussions on aesthetic body and, as well as evidencing dialogues between different areas of the knowledge, as the Art and the Physical Education. From the point of view of the method, the work follows orientation of the Phenomenology for an aesthetic image appreciation of the videos in the choreographies In'perfeito and Violência of Cena 11, Dance Group that has marked new aesthetic configurations in the brazilian dance. Thus, we took for us the reflections on the "significant scenes" proposed by Bicudo (2000), to appreciate the dance of Cena 11. We emphasize that, after the identification of the Significant Scenes, it was necessary to approach these scenes from close senses, from which we detach the appearance, the space and the gesture. We evidence that, the bodies revealed by the group Cena 11, show an aesthetic that it interlaces the beauty, the ugly and the grotesque. An aesthetic of the unharmony, capable to transgress the oppositions, dialoguing with multiple antagonisms and that it amplifies the apollonian aesthetic linear rules, so predominant in the history of the dance and the Physical Education. We identify some indicatives that take us to the problematizations on an affective and anarchic body, when questioning the tyranny of the perfect corporality; the naturalization of the pain; the closed gesture in a finished and unique grammar; the standardization of feminine and masculine roles and the negation of the feeling. From these indicatives, we discuss the aesthetic of the deformed bodies of Cena 11, approaching it of the conceptions of body in the Physical Education, sometimes criticizing the rationalists and naturalistic views, sometimes dialoguing with more recent perspectives studied by researchers of this area of knowledge, which point to a reflection on the body under the optics of the sensible

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

Validação de protocolo de assistência para pessoas com úlcera venosa na atenção primária

People with venous ulcers constitute as an important public health problem, its treatment is onerous and require assistance provided by trained professionals, systematized through protocols, however what lies in the assistance is that the management of this group of people differs from that preconized in the scientific literature, interfering with wound healing and quality of life of affected. In this sense, the construction of a assistance protocol specific to people with venous ulcers (VU) can help professionals of the Family Health Strategy both in patient assessment as and in establishment of quality assistance. Thus, this study aimed to analyse the validity of a multiprofessional assistance protocol for people with venous ulcers in primary care by health professionals using Delphi technique. This is a quantitative study, the methodological type conducted in two steps: first step related to integrative literature review to subsidize the development of the protocol, then these aspects were organized and proposed to the judges of the study through the Delphi technique. The study was initiated after approval by the Research Ethics Committee. The first step was performed between August and September 2012, in the virtual library of health, in the page of the Coordination of Improvement of Higher Education Personnel, of Municipal Health Secretariat and international guidelines of associations and in the subsequent step carried out between September 2012 to January 2013, was performed search by Lattes platform of the National Council of Technological and Scientific Development, in order to identify health professionals in Brazil who act as judges of the instrument and then, via online, the form was submitted to them.The sample for the second step was 51 judges in the first round and 35 for the second round Delphi. The analysis was done by adopting Kappa index ≥ 0.81 and Content Validity Index (CVI)> 0.80. In the first submission for the judges, items that did not reach Kappa and CVI established were: request / realization / test results, demographic data, medical history, risk factors, verification of pain / vital signs / pulse / infection signs / lesion location/ edema and pain treatment. After removal of items which have not obtained Kappa or CVI index established, it was found achieving optimal levels of these index for the categories. In the next step was the ressubmissão of protocol to judges through the Delphi technique in it was found that, of the 15 categories of the protocol, 12 presented higher scores in Delphi 2 phase and the other three categories remained the same Kappa and IVC of the previous phase. As for the average of evaluation requirements of the protocol was found that the scores assigned by the judges were higher in the second phase in nine of the 10 items, remaining the same in only one of the items indicating validity of the instrument before the consensus of the judges. Thus, we accepted the alternative hypothesis in this study, as they were obtained in the second Delphi phase the validity index greater than or equal to the Delphi 1 phase. The formulation of this assistance protocol valid and reproducible will enable a reorganization and redesign of assistance, with standardization of actions and continuity of care for persons with venous ulcers in primary health care

Atendimento Pré-hospitalar Móvel. Mapeando Riscos e Prevenindo Erros

The attention with safety of the patients is important in the quality of the nursing and health care. In the pre-hospital care, such care is essential on site with the purpose of avoiding possible consequences to the individual, ensuring a fast and appropriate care, with improvement of the morbidity and reduction of the mortality. This medical attention is equally associated with the significant risks of adverse events and serious mistakes, which can be reduced with the awareness of the professionals, organization and quality management. It is a descriptive, transversal research, of quantitative approach, with the objective of identifying the risks for the safety of the patient during the mobile pre-hospital care under the view of the nurses, in a city of the Brazilian Northeast. The sample was formed by 23 nurses. The inclusion criteria: to have at least two years of experience and accept to participate on the research. The data collection was done in two steps, first photo collection, through the adapted method of photographic analysis, and the second with the application of questionnaire, divide in two parts: socio-professional data and digital photo punctuation instrument of the patient s safety. The majority of the nurses had an average working time in the mobile pre-hospital care of six years and six months, in the age group of 38 to 53 years old (69,56%) and with Lato sensu specialization (73,91%), being (29,41%) emergency and (29,41%) in intensive care. The (74%) have the Advance Cardiac Life Support (ACLS) and (100%) have the Pre-Hospital Trauma Life Support (PHTLS); (91, 30%) know the thematic safety of the patient. On the pictures it was observed a bigger variability of the categories (risks) where 44% of variance emerged on the first picture of the research. The pictures 4 and 9 with the average below 5 were classified as very insecure, while pictures 7 and 3 with an average above 7, very secure. On the results of risks observed for the patient s safety in the mobile pre-hospital care five categories emerged: organization and packaging of the equipment and materials, routines and specificities in the mobile pre-hospital care, risks on the management of medications, for traumas and infections. Starting from the analysis of these risks, it was proposed ten steps for the safety in the mobile pre-hospital care: 1- Identify the patient; 2- Safety related to prevention of infection; 3- Safety in the management of medications; 4- Safety and standardization of the packaging of equipment and materials; 5- Attention to the specificities of the mobile pre-hospital care; 6- Incentive and value the participation of the patient and family; 7- Promote the communication with the central of regulation; 8- Prevention of traumas and falls; 9- Protect the skin from additional injuries; 10- Understand the benefit of all the equipment in the ambulance. The multiple risks and their emerged combinations on the research indicate a variety of actions to be developed and stimulated, like the use of steps for the patient s safety in the mobile pre-hospital care which contributes with the aid and management of risks, reduction of mistakes, disabilities and death