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

Avaliação da assistência à saúde dos portadores de úlceras venosas atendidos no programa saúde da família do município de Natal/RN

Descriptive research aimed at evaluating the assistance offered to patients with venous ulcers, on lower limbs, attended by the Family Health Program (FHP) team, from the municipality of Natal/RN. The target population was composed of 74 patients with venous ulcers (VU), attended by the FHP teams in the 31 FHUs. The study was approved by the Ethics Committee of the Federal University of Rio Grande do Norte (protocol n.55/05). The data collection was performed in patients homes and in the FHUs, through structured interviews and physical examinations of patients with VU and non-participant observation during the changing of wound dressings in these Units and in users homes. The data was organized into an Excel electronic table and transported into the SPSS 14.0 program, for descriptive analysis on 2x2 contingency tables and inferential (Qui-Square χ2, Spearman Correlation, Binomial Proportion Test and p-value <0.05). The prevalence of VU (0.36/1000) in the target population (over 20 years of age) was greater than in the population registered in FHP (0.25/1000). We detected a greater prevalence in the age area of over 60 years (2.22/1000), with 2.98/1000 for females and 1.3/1000 for males (p-value=0.008). The sociodemographical and health characteristics of patients with VU revealed predominance of females (74.5%), elders over 60 years of age (67.6%), with fundamental education (74.3%), family earnings of up to 2 minimum wages (68.9%), retired (90.5%), ortostatic position (23.0%), inadequate sleep (59,9%), presence of CVI (100.0%), hypertension (44.6%) and diabetes (25.7%). As for the time of existence of the VU, 64.9% had over 1 year, and 35.1% less than 1 year), with predominance of one wound (67.6%). The changing of wound dressings is performed mostly at home, in and inadequate way, especially with incorrect cleaning techniques, likewise incorrect use of products and substances, and reduced participation of the FHP team on the evaluation and application of the dressing and choosing of products and substances. The compressive therapy is not part of therapeutic conducts for treatment in the FHUs. As for the evaluation of assistance to patients with VU, 90.5% were inadequate and only 9.5% adequate. The main inadequacy factors were the absence of: diagnosis (47.3%), consultation with and angiologist (63.5%), compressive treatment (100.0%), adequate optical therapy (98.62%), adequate dressing kit (70.3%), training for the changing of dressings (67.6%), following by the FHP team (51.4%) and performed exams (55.4%). We ve concluded that patients with VU mostly present now socioeconomical level and associated chronic diseases. Considering that assistance offered by FHP is non-systematic, fragmented, with no diagnosis planning, continual evaluation and evolution, we qualify the assistance as inadequate and with low level of solution, directly interfering on the maintenance of the VUs chronic state

Análise da adesão ao tratamento e da qualidade de vida de pessoas com úlcera venosa

The therapeutic adherence is still a big problem among people with venous ulcers (VU) because the treatment is long, expensive and demand changes in lifestyle. In this context, this study aims to examine treatment adherence and quality of life (QOL) of people with VU assisted at primary health care. This is an analytical, cross-sectional study with a quantitative approach to treatment and data analysis. The study had the scenario 13 Family Health Units and 02 Units Mixed of Natal. The target population consisted of 44 persons with UV indicated by the teams of the Family Health Strategy between February and April 2014. Three instruments were used: an instrument to characterize the sociodemographic, health and care aspects, the Multidimensional Scale of Adherence Therapy composed of the dimensions: healthy lifestyle, compressive therapy and neurovascular monitoring and the Charing Cross Venous Ulcer Questionnaire (CCVUQ) that evaluates QOL in persons with VU composed by the domains: Total Score, Social Interaction, Domestic Activities, Aesthetics and Emotional State. The study was approved by the Ethics Committee in Research of the Federal University of Rio Grande do Norte, CAAE: 07556312.0.0000.5537. The data concerning the sociodemographic characteristics showed that there was a predominance of females (65.9%), age range as of 60 years (59.1%) and income of up to 1 minimum wage (81.8%). With the characterization of health, it was evident that most people reported chronic diseases (63.6%), sleep more than 6 hours (81.8%), present pain (81.8%), denying alcoholism (86 4%) and smoking (77.3%) and showed a number greater than or equal to 1 (77.3%) recurrences. Concerning the therapeutic adherence was found that in the dimension compressive therapy there poor adherence. No associations between the domains of adherence and sociodemographic and health variables were found. Was observed, however, better adherence among individuals without pain and with higher schooling. When analyzed the averages of the dimensions of therapeutic adherence with the care characteristics there was statistical significance between: adherence to compression therapy and guidance for use of compressive therapy (p = 0.002) and guidance for regular exercise (p = 0.026). Considering the mean of total score of CCVUQ (mean 51.47, SD 18.33) it is observed that the overall QOL of respondents has approximate value of the median of the scale (50). The mean of the domain Social Interaction (mean 44.23, SD 21.38) and Domestic Activities (mean 45.70, SD 23.21) were those who reported better QOL. There were weak correlations but significant between adherence to healthy lifestyle and Domains Total Score (p = 0.012), social interaction (p-value = 0.048), Aesthetics (p-value = 0.025) and Emotional State (0.017) of CCVUQ. From the data analysis it is concluded that among people with UV, there poor adherence to compressive therapy. Furthermore, we found no statistically significant association between treatment adherence and sociodemographic and health characteristics. It is added that there was a correlation between the healthy lifestyle dimension and domains CCVUQ

Úlceras de pressão: um estudo com pacientes de unidade de terapia intensiva

To characterize patients according to gender, age category, internment time, diagnostical hypothesis and location of the pressure ulcer; to identify the susceptibility conditions, intrinsical and extrinsical factors present on ICU patients and to verify on the existence of association between the susceptibility conditions and the intrinsecal and extrinsecal factors on the occurrence of PU. Methods: It is a descriptive study, of longitudinal design of the panel type, with quantitative approach, performed on two ICU s of a private hospital located in Natal/RN, with 40 patients interned at these units. The data collection was performed on all three shifts through a structured observation and physical exam of the patients' skin form seeking to identify the presence of PU. Results: The greatest occurence of PU was on individuals of the male gender (70%) when compared to the female gender (30%), that difference being statistically significant (p=0,0267), with the male gender presenting 4,3 times greater chance of developing PU than the female; the predominant age category was from 60 years of age on (85%), 60,0% presented 1 to 2 PU s after 7 (seven) days of permanence in the ICU s, the predominant diagnostical hypothesis on the patients with PU were the respiratory diseases (42,3%) and the most frequent locations of PU were the sacral region (40,0%) and heels (36,0%). 25 PU s of stage I were diagnosed on 50,0% of the followed patients, with general incidence of 50,0% on both ICUs. from the 88 variables researched, 75 were identified on the patients from the study, being the predominant conditions (anemia, hypotension, leukocytosis, other diseases hypertension blood pressure, cardiac insuffience, pneumonia - and ansiolythic), the intrinsecal factors (diminished muscular strenght and/or mass, discrete edema, totally compromised mobile coordination and total inability for movement on the bed) and the extrinsecal factors (inadequate mattress type, permanence on a single position for >2 hours, shearing/friction force, bed clothes with folds that leave marks on the body, pressure force) predominated on patients with PU. The male gender variables (p=0,0267,OR=4,3), sedation (p=0,0006,OR=4,1), psychomotive agitation (p=0,0375,OR=5,8) and leukocytosis (p=0,0285,OR=5,0) presented a significant statistical diference when analyzed independently. We verified an association of 17,3%, statistically significant (p=0,0384), between the susceptibility conditions (anemia, leukocytosis and hypotension), the intrinsecal factors (age equal or above 60 years, diminished/absent pain sensibility and smooth, fine or delicate skin) and the extrinsecal factors (inadequate mattress, pressure forces, shearing/friction force, permanence on a single position for more than 2 hours, elevation between 30 to 45 degrees and inadequate bed clothes' conditions), with a chance ratio of 4,6 times the risk of occurrence of PU on the patients that presented the referred association. Conclusion: The incidence of PU detected on the ICU-interned patients was high and we made evident the existence of association between the susceptibility conditions, the intrinsecal and extrinsecal factors on the occurrence of PU s on the ICUinterned patients, and thus we accept the alternative hypothesis proposed on the study

Análise de Argamassas Com Substituição Parcial do Cimento Portland Por Cinza Residual de Lenha de Algaroba

With the increase in cement consumption, it has quickly become one of the inputs most consumed by mankind over the last century. This has caused an increase in CO2 emissions, as cement production releases large quantities of this gas into the atmosphere. Adding this fact to the growing consciousness of environmental preservation, it has led to a search for alternatives to cement to complement its derivatives, in the form of waste materials like the ashes. This research aimed to analyze the properties of mortars in fresh and hardened state with partial replacement of Portland cement by residual algaroba wood ash (CRLA) potteries produced by the state of Rio Grande do Norte. The CRLA was collected and sieved, where part of it was ground and characterized in comparison with that just sifted, being characterized according to its chemical composition, grain size, fineness, density, bulk density and index of pozzolanic activity. It was found that the wood ash does not act as pozzolan, and grinding it has not changed its characteristics compared to those just sifted, not justifying its use. Two traces were adopted for this research: 1:3 (cement: fine sand) and 1:2:8 (cement: hydrated lime: medium sand); both in volume, using as materials the CRLA just sifted, CP II F-32 Portland cement, CH-I hydrated lime, river sand and water from the local utility. For each trace were adopted six percentages of partial replacement of cement for wood ash: 0% (control) 5%, 7%, 10%, 12% and 15%. In the fresh state, the mortars were tested towards their consistency index and mass density. In the hardened state, they were tested towards their tensile strength in bending, compressive strength and tensile adhesion strength, and its mass density in the hardened state. The mortar was also analyzed by scanning electron microscopy and X-ray diffraction. Furthermore, it was classified according to NBR 13281 (2005). The results showed that up to a content of 5% substitution and for both traces, the residual algaroba wood ash can replace Portland cement without compromising the mortars microstructure and its fresh and hardened state

Análise do Comportamento Mecânico de Concretos Produzidos com Incorporação de Cinza do Bagaço da Cana-de-Açúcar de Variedades SP911049, RB92579 E SP816949

Concrete is the second most consumed product in the world and the incorporation of the Sugar Bagasse Ash (SBA) into this material can provide solutions for the utilization of by-products from other industries, thus reducing the environmental impact. The general aim of this dissertation focuses on analyzing the mechanical behavior of concrete with addition of SBA from three different species of sugar cane, through tests of consistency, compressive strength, porosity, absorption, voids and Scanning Electron Microscopy (SEM). Were prepared 13 specimens for each specific pattern and level of incorporation of SBA (10%, 20% and 30%) of the three varieties collected, totaling 130 samples of concrete. The trait was employed 1:2:3 (cement: sand: aggregates) in relation to the cement mass with a water / cement ratio of 0.532 and 1% additive Tec 400 Mult also based on the weight of cement. According to the results obtained in this study, it was concluded that the variety of cane sugar, used in the production of the CBC, influenced the mechanical behavior of the resulting concrete. All concrete with addition of SBA, reported a reduction of at least 10% in the properties related to permeability and an increase in the compressive strength of at least 16% compared to standard concrete at 28 days

Estudo de concretos de diferentes resistências à compressão submetidos a altas temperaturas sem e com incorporação de fibras de politereftalato de etileno (PET)

The reinforced concrete structures are largely used in buildings worldwide. Upon the occurrence of fire in buildings, there is a consensus among researchers that the concrete has a high resistance to fire, due mainly to its low thermal conductivity. However, this does not mean that this material is not affected by exposure to high temperatures. Reduction of the compressive strength, modulus of elasticity, discoloration and cracking, are some of the effects caused by thermal exposure. In the case of concretes with higher resistance occurs even desplacamentos explosives, exposing the reinforcement to fire and contributing to reducing the support capacity of the structural element. Considering the above, this study aims to examine how the compressive strength and porosity of concrete are affected when subjected to high temperatures. Were evaluated concrete of different resistances, and even was the verified if addition fibers of polyethylene terephthalate (PET) in concrete can be used as an alternative to preventing spalling. The results indicated that explosive spalling affect not only high strength concrete whose values of this study ranged from 70 to 88 MPa, as well as conventional concrete of medium strength (52 MPa) and the temperature range to which the concrete begins to suffer significant changes in their resistance is between 400 º C and 600 º C, showing to 600 º C a porosity up to 188% greater than the room temperature

Avaliação do concreto de cimento portland com resíduo da produção de scheelita em substituição ao agregado miúdo

From the 70`s, with the publication of the Manifesto for Environment UN Conference, held in Stockholm, in Sweden (1972), defend and improve the environment became part of our daily lives. Thus, several studies have emerged in several segments in order to reuse the waste. Some examples of waste incorporated in portland cement concrete are: rice husk ash, bagasse ash of cane sugar, powder-stone, microsilica, tire rubber, among others. This research used the residue of the mining industry Scheelite, to evaluate the incorporation of the residue composition of Portland cement concrete, replacing the natural sand. The percentage of residue were incorporated from 0% to 100%, with a variation of 10%, 11 being produced concrete mix in the ratio 1:2:3:0.60, by mass. We evaluated the following characteristics of concrete: slump test, compressive strength, tensile strength by diametral compression, water absorption, porosity and density, based on the ABNT, through tests performed in the Laboratory of Civil Construction, UFRN. The trace with the addition of 60% scheelite residue was obtained which better performance. Therefore, the use of the waste from the production of Scheelite is feasible due to the durability parameters (water absorption and porosity), sustainability, and the good results of the resistance of the concrete

Estudo da viabilidade da utilização de cinza de lodo de esgoto como adição em argamassa de cimento Portland

The use of sewage sludge as a raw material falls within the waste recycling key in the current process model environmental sustainability .Waste recycling has been consolidated as a sustainable environmentally sound technical solution, and. Despite showing very variable composition and characteristics, sewage sludge, can be considered as a residue with a high recycling potential in the building sector. In this paper the feasibility of using sewage sludge ash was studied in addition to Portland cement mortar in 1:3 mass considered the standard dash. This gray additions were studied in proportions of 5%, 10 %, 15 %, 20 %, 25% and 30% by mass of cement. The methodology was focused on the characterization of materials by physical, chemical , mechanical , environmental and morphological followed by the production of mortar tests ,and finalized by the characterization tests of mortar in the fresh state, through the consistency index, content of entrained air, bulk density and water retention, and in the hardened state by bulk density, water absorption by capillarity capillarity coefficient, compressive strength, tensile strength in bending ,tensile bond strength and microstructural analysis for percentages of 0 to 20%. After comparing with the standard mortar mortars with addition of ash, it is concluded that the ash of sewage sludge did not impair the integrity and properties of mortars with addition, including increasing resistance to compression and tension, being 20% more indicated percentage. Thus, it becomes feasible the addition of sewage sludge ash in Portland cement mortar for the trait studied

Desempenho de argamassas produzidas com agregados reciclados oriundos do resíduo de construção e demolição da Grande Natal-RN

The construction industry is responsible for generating a lot of waste because of their activities. Consequently, it is noticeable the occurrence of environmental problems in terms of its disposal in inappropriate places. Faced with this problem, some studies have been conducted with the aim of developing technologies and alternatives for recycling construction and demolition waste (CDW), motivated by the scarcity of natural resources and reduction of environmental problems generated. The research aims to characterize the recycled aggregates derived from construction and demolition waste (CDW) produced in the Greater Natal-RN and analyze the performance of mortar coating produced with recycled aggregates. The study includes the chemical , physical and microstructural characterization of recycled aggregates , as well as conducting microscopic analysis and laboratory tests in the fresh state (consistency index , water retention , bulk density and content of entrained air ) and in the hardened state ( compressive strength , tensile strength in bending , water absorption by immersion and capillary , mass density and void ratio ) for mortars produced from different levels of substitution of aggregates ( 0, 20 %, 40 %, 60 %, 80 % and 100 %). The results were satisfactory, providing mortars produced with recycled aggregates, smaller mass density and dynamic modulus values as well as an increase in the rates of absorption and porosity. The tensile strength in bending and compression for TP1 (1:2:8) trait were lower for mortars produced with recycled aggregates and the best result was 20% for replacement. For the TP2 (1:8) mapping, there was an increase in resistance to traction and compression and the best result was for 100% replacement of natural aggregates by recycled. The experiments led to the conclusion that the technical and economic point of view that the mortars produced with recycled aggregates can be used in construction, only if there is an effective control in production processes of recycled aggregate and at the dosage of mortars

Physical and mechanical properties of thermally modified wood from E. grandis

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Resistência a compressão de tijolos de solo-cimento fabricados com o montículo do cupim Cornitermes cumulans (Kollar, 1832)

Objetivou-se neste trabalho, comparar a resistência à compressão de tijolos de solo-cimento fabricados com o montículo do cupim Cornitermes cumulans (Kollar, 1832), com tijolos que utilizaram como matéria prima um NEOSSOLO QUARTZARÊNICO (Empresa Brasileira de Pesquisa Agropecuária (EMBRAPA), 1999), ambos submetidos a duas idades de cura (07 ou 28 dias). O experimento foi montado em delineamento inteiramente casualizado, em esquema fatorial 2x2, sendo analisados dois cofatores: a matéria prima base e a idade de cura. Os ensaios físicos e mecânicos obedeceram às prescrições das normas da Associação Brasileira de Normas Técnicas NBR-8492 (ABNT, 1982) e NBR-8491 (ABNT, 1984). Concluiu-se que a resistência à compressão dos tijolos foi maior com o aumento das idades de cura. O tratamento T4 apresentou maior valor de resistência à compressão, não diferindo estatisticamente dos tratamentos T2 e T1. Os tijolos fabricados com o montículo do cupim C. cumulans (Kollar, 1832) apresentaram diminuição da absorção de água com o aumento das idades de cura, o que normalmente corresponde a um maior aumento da resistência à compressão, ao contrário dos que utilizaram o NEOSSOLO QUARTZARÊNICO (Empresa Brasileira de Pesquisa Agropecuária (EMBRAPA), 1999).

Adição de geomanta e tecido não tecido de polipropileno em cimentos geopoliméricos de pega rápida

Geopolymers are cementing materials that depict a number of advantages compared to Portland cement. Contrary to the latter, geopolymers are synthesized at room temperature, thus significantly reducing the emission of CO2 to the atmosphere. Moreover, the composition and synthesis reactions can be tailored to adjust the setting time of the material as well as its compressive mechanical strength. It is then possible to produce geopolymeric cements with short setting times and high compressive strength, although relatively brittle. The objective of the present study was to produce and characterize composite materials by reinforcing fastsetting geopolymeric matrixes with polypropylene geosynthetics (geomats and geotextiles) in an attempt to improve the toughness and tensile strength of the cementing material. Geosynthetics have been increasingly used to reinforce engineering structures, providing higher strength and better toughness. In particular, polypropylene nonwoven and geomats depict other attractive properties such as low density, durability, impact absorption and resistance to abrasion. Fast-setting geopolymers were then synthesized and reinforced with polypropylene nonwoven and geomats. The mechanical strength of the materials, reinforced or not, was characterized. The results showed that relatively short setting times and adequate flowing behavior were achieved by adjusting the composition of the geopolymer. In addition, it is possible to improve the fracture resistance of geopolymeric cements by adding polypropylene geosynthetics. The best results were achieved by reinforcing geopolymer with polypropylene TNT

Análise comparativa entre propriedades mecânicas, termofísicas e geométricas de tijolos produzidos pelos fornos caieira e abóbada

In the State of Rio Grande do Norte potteries are distributed in several counties in the four meso, which are: West Potiguar, Center Potiguar, Agreste Potiguar and East Portiguar. The ceramics, mostly, are responsible for products used in construction as bricks, tiles and white brick and wood used as fuel. This paper had a primary focus in the region of Seridó. The furnaces in this region, used to manufacture bricks are configured Caieira and Valt, in most of them using principles rustic, usually operated in an empirical way, using principles of control rather primitive, predominantly visual control. The focus of this study was to analyze the differences in the thermophysical, mechanical and geometric characteristics of bricks produced by Caieira and vault furnaces, using the NBR 15720 and the evaluation of energy efficiency in both furnaces. Thermophysical characteristics were analyzed through tests to determine the water absorption obtained from the difference between dry mass and wet mass of the sample and analysis of the thermal gradient, the mechanical characteristics from determination of the compressive strength of ceramic brick popularly known as bricks and also analyzed the geometrical characteristics of the bricks in order to verify the homogeneity of manufacturing. The tests showed that the energy difference of the two furnaces is not considered responsible for a significant difference in the properties of the products

Obtenção de compósitos cerâmicos reforçados com carbetos refratários a partir de precursores poliméricos

In this work, were produced ceramic matrix composites based in SiCxOy e Al2O3 reinforced with NbC, by hydrosilylation reaction between D4Vi and poly(methylhydrosiloxane) mixtured with Al2O3 as inert filler, Nb and Al as reactive filler. After the mixture and compactation at 80ºC (warm pressing), the samples were pyrolised at 1200 and 1400ºC and infiltred with ICZ and LZSA respectively, and thermically, physical and structurally characterized by X-ray diffraction, density and porosity, flexural mechanical strength and fracture surface by scanning electron microscopy. The yield ceramic obtained after pyrolysis for studied composition at 1200ºC was 95%. The obtained phases had been identified as being Al3Nb, NbSi2 and NbC. The composite material presented apparent porosity varying of 15 up to 32% and mechanical flexural strenght of 32 up to 37,5MPa. After the fracture surface analysis, were observed a phases homogeneous dispersion, with some domains of amorphous and crystalline aspect. The samples that were submitted the infiltration cycle presented a layer next the surface with reduced pores number in relation to the total volume