Protocol Proposal For The Care Of The Person With Venous Ulcer

Objective: To propose a care protocol for the care of the person with a venous ulcer in highly complex services. Methods and results: This is a methodological study, in three stages: literature review, validation of content and validation in the clinical context. The literature review was carried out from June to August/2011, being the basis for the construction of the Protocol for Venous Ulcers. The content validation included 53 judges (44 nurses, 8 physicians and 1 physiotherapist) selected through the Lattes platform to evaluate the items of the protocol. Validation in the clinical context occurred at the University Hospital Onofre Lopes, in Natal/RN with four judges (nurses), who worked in pairs, evaluating 32 patients with venous ulcers. The protocol was validated with 15 categories: sociodemographic data; anamnesis; examinations; ulcer characteristics; care with the lesion and perilesional area; medicines used to treat the lesion; evaluation and treatment of pain; surgical treatment of chronic venous disease; recurrence prevention (clinical and educational strategies); reference; counter-reference; and quality of life. Conclusion: The validated protocol regarding content and clinical context was applicable. Its implementation is a viable measure that assists in the reorientation of the team in high complexity services, aiming at wound healing and restoration of the patient´s integral health. Keywords: Varicose ulcer; Tertiary Health Care; Protocols; Validation studies

Recomendações para o cuidado do paciente oncológico no contexto do novo coronavirus: scoping review

: O mundo enfrenta uma pandemia causada pelo SARS-CoV-2, onde desde dezembro de 2019 soma-se a cada dia mais vítimas. O estudo tem como objetivo mapear as principais recomendações adotadas no cuidado ao paciente oncológico durante a pandemia do novo coronavírus. Esta é uma revisão de escopo, desenvolvido em agosto de 2020. Para a pesquisa foi utilizado o portal de Periódicos da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, buscando nas bases de dados Literatura Latino-americana e do Caribe em Ciências da Saúde (LILACS), essa Scopus, Web of Science (WOS), Sistema Online de Busca e Análise da Literatura Médica (MEDLINE) e Cumulative Index to Nursing and Alied Health Literature (Cinahl) na biblioteca eletrônica Sientific Eletronic Library Online (SciELO) e no Catálogo de Teses e Dissertações da CAPES utilizando os seguintes descritores: Assistência à Saúde (Delivery Of Health Care), Oncologia (Medical Oncology) e Infecções por Coronavirus (Coronavirus Infections) e utilizou-se os operadores booleanos AND e OR. A partir das buscas observou-se que durante a atual pandemia, os pacientes oncológicos precisam conviver com diferentes dificuldades, seja a questão do atraso do tratamento causado pela lotação do serviço público de saúde, e também a questão da imunossupressão que os deixam ainda mais susceptíveis ao vírus. Tendo em vista essa situação, é necessário se adaptar a essa nova realidade e continuar promovendo o cuidado

Valiação do grau de implantação dos atributos da atenção primária à saúde como indicador da qualidade da assistência prestadas às comunidades quilombolas no estado do Rio Grande do Norte

Assessment of the level of implementation of primary health care attributes as an indicator of the quality of care provided to quilombola communities in the state of Rio Grande do Nort

Prevalência e fatores associados à discriminação racial percebida nos serviços de saúde do Brasil

Objective: To analyze the prevalence of race/color discrimination practiced by healthcare providers in Brazil and its associated factors. Methods: Cross-sectional study based on data from the 2013 National Health Survey (PNS). The dependent variable was elaborated from the answer to question X25 - Have you ever felt discriminated against or treated worse than other people in the health service? The independent variables used in the study were: region of residence in the country, domicile situation, skin color, sex, age group, living with spouse, occupation, education, social class criterion in Brazil, smoking, alcoholism, presence of multimorbidity, self-rated health and use of a private medical or dental health plan. These factors were analyzed through the Prevalence Ratios (PR), with Poisson Regression multivariate analysis (95% CI), using the Wald test for robust estimation. Results: The prevalence of race/color discrimination was 1.45%% (n = 6055), associated with being black (PR 3.74 95% CI 2.89-4.85), aged 25-39 years (PR 1.89 95% CI 1.21-2.55), being a smoker (PR 1.55 95% CI 1.17-2.09), having four morbidities (PR 2.54 95% CI 1.62-3 99), evaluate their health as poor or very poor (PR 1.76 95% CI 1.25-2.48), be a public health service user (PR 1.33 95% CI 1.02-1.73 ), and reside in the urban area of the country (PR 1.48 95% CI 1.10-1.98). Conclusion: It was possible to identify that the discrimination by race/color practiced by healthcare providers in Brazil has low prevalence, which may be related to the cultural, social and legal constructions and sanctions involved in this phenomenon.Objetivo: Analizar la prevalencia de la discriminación de raza/color practicada por los prestadores de cuidados de servicios de salud de Brasil y sus factores asociados. Métodos: Estudio transversal realizado a partir de los datos de la Investigación Nacional de Salud (INS) de 2013 con la variable dependiente elaborada a partir de la respuesta de la pregunta X25: Usted ya se sintió discriminado(a) o tratado(a) peor que las otras personas en el servicio de salud? Las variables independientes fueron: la región de vivienda en el país, la situación del hogar, la raza/color, el sexo, la franja de edad, si vive con pareja, la ocupación, la escolaridad, el criterio de clase social en Brasil, el tabaquismo, el alcoholismo, la presencia de multimorbidad, la auto evaluación de la salud y el uso de seguro privado de salud médico o de salud bucal. Eses factores han sido analizados a través de las razones prevalencia (RP), el análisis multivariado por la regresión de Poisson (IC95%), la prueba de Wald para estimación robusta. Resultados: La prevalencia de la discriminación de raza/color ha sido del 1,45% (n=6055) asociada con el hecho de tener el color negro (RP 3,74 IC95% 2,89-4,85), tener la edad entre 25-39 años (RP 1,89 IC95% 1,21-2,55), ser fumador (RP 1,55 IC95% 1,17-2,09), tener cuatro morbidades (RP 2,54 IC95% 1,62-3,99), evaluar la propia salud como mala o muy mala (RP 1,76 IC95% 1,25-2,48), ser usuario del servicio público de salud (RP 1,33 IC95% 1,02-1,73) y vivir en la zona urbana del país (RP 1,48 IC95% 1,10-1,98). Conclusión: La discriminación de raza/color practicada por los prestadores de cuidados de salud de Brasil presenta baja prevalencia lo que puede estar relacionado con las construcciones y sanciones culturales, sociales y legales de ese fenómeno.Objetivo: Analisar a prevalência da discriminação por raça/cor praticada por prestadores de cuidados em serviços de saúde no Brasil e seus fatores associados. Métodos: Estudo transversal realizado a partir dos dados da Pesquisa Nacional de Saúde (PNS) de 2013, com variável dependente elaborada a partir da resposta à questão X25: O(A) Sr(a) já se sentiu discriminado (a) ou tratado(a) pior do que as outras pessoas no serviço de saúde? As variáveis independentes foram: região de moradia no país, situação de domicílio, raça/cor, sexo, faixa etária, vive com cônjuge, ocupação, escolaridade, critério de classe social no Brasil, tabagismo, alcoolismo, presença de multimorbidade, autoavaliação de saúde e uso de plano privado de saúde médico ou odontológico. Esses fatores foram analisados através das razões de prevalência (RP), com análise multivariada pela regressão de Poisson (IC95%), com teste de Wald para estimação robusta. Resultados: A prevalência da discriminação por raça/cor foi de 1,45% (n=6055), associada a ser negro (RP 3,74 IC95% 2,89-4,85), ter idade entre 25-39 anos (RP 1,89 IC95% 1,21-2,55), ser fumante (RP 1,55 IC95% 1,17-2,09), possuir quatro morbidades (RP 2,54 IC95% 1,62-3,99), avaliar a própria saúde como ruim ou muito ruim (RP 1,76 IC95% 1,25-2,48), ser usuário do serviço público de saúde (RP 1,33 IC95% 1,02-1,73) e residir na zona urbana do país (RP 1,48 IC95% 1,10-1,98). Conclusão: A discriminação por raça/cor praticada por prestadores de cuidados de saúde no Brasil apresenta baixa prevalência, o que pode estar relacionado às construções e sanções culturais, sociais e legais envolvidas nesse fenômeno

Factors Influencing the Decision-Making Process at the End-of-Life Cycle of Onshore Wind Farms: A Systematic Review

It is observed that the number of onshore wind farms that reach the end of their service life is continually increasing. The decision-making process that defines the future of the farm is a challenge for the owners. This systematic review aimed to identify which factors influence the decision-making process at the end-of-life cycle of onshore wind farms. In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol, a research strategy was developed and used the Scopus, Web of Science and EMBASE databases. Initially, 2767 articles were identified, but, after double-blind screening, 26 articles were analyzed in full. The scarcity of studies on this topic and little elucidation are limitations of this review. The results include (i) a systematization of six options for decision making, (ii) thirteen factors influencing the decision-making process associated with categories of external factors (logistics and infrastructure aspects, regulatory aspects and public policies, national energy guidelines, the technological development of the sector); and internal factors (economic/financial, operational and environmental aspects). It is concluded that most of the publications consist of simulations and theoretical studies highlighting a bottleneck in experiences and feasible data to support decisions at the end of service life. It is highlighted that most of the studies showed that partial decommissioning with partial repowering, as well as total decommissioning, were the most feasible options for the end-of-life cycle, with aspects related to public policies and regulatory aspects, as well as environmental, operational and economic/financial aspects, being the most influential, especially due to the wake effect, operation and maintenance costs (OPEX) and the protection of guarantees and incentives for operation in a new operating cycle

Quality Of Care Indicators Of A Pre-Hospital Mobile Emergency: A Review

Objective: To identify the quality of care indicators in pre-hospital mobile emergency services. Methods and results: This study is a systematic review conducted in December/2015 in eight databases using the keywords: quality indicators in health care; pre-hospital care; and quality, access, and evaluation of the health care. Seventeen studies were selected and the following indicators were identified: conservation of the ambulances; physical structure; comfort in the ambulance; material resources; safety for the patient/professional; continuing education; response time; professional remuneration; professional/patient satisfaction; access; host; humanization; performed service; safety demonstrated by the team; privacy to the patient; guidelines on care; relationship between the professional/patient; opportunity of the patient to complaint. Conclusion: The establishment the of the quality of care indicators the in mobile emergency services will allow the construction of instruments to evaluate this type of service to search for excellence results in mobile emergency services

Evaluation Of The Quality Of Assistance In An Pre-Hospital Mobile Emergency Service

Background: to evaluate the quality of the assistance of a Mobile Emergency Care Service and to compare the evaluation of professionals according to training and level of education. Methods and Findings: this is a cross-sectional study, with a Donabedian theoretical reference. The sample was all the professionals of a Mobile Emergency Service and data collection performed by a previously validated quality assessment instrument. Some aspects of the service structure were evaluated negatively, and the process was evaluated in a positive way, in general. When comparing the evaluation of quality according to professional category and education, it was verified that the indicators of structure and process were considered appropriate by the professionals of average level and inadequate by the personnel of superior level. Conclusion: the professionals identified flaws in the service structure, which can impact the assistance provided. The level of education influenced the evaluation of the quality of the service. Keywords: Emergency medical services; Health Evaluation; Prehospital care; Evaluation studies; Health services &nbsp

Characterization of Publications on Burns in Brazil and Changes Resulting from Trauma in Brazil: Systematic Review of the Literature

Objective: Characterize the profile of scientific publications on burns in Brazil and systemic changes resulting from the trauma. Methods and results: This is a bibliographical, retrospective and descriptive research with a quantitative approach. It was held between April and May, 2016 in the databases Latin American and Caribbean Center on Health Sciences (LILACS); Nursing Database (BDENF); Medical Literature Analysis and Retrieval System Online (MEDLINE), Scientific Electronic Library Online (SciELO) and the Journal Portal of Higher Education Personnel Improvement Coordination (CAPES). After the analysis of the inclusion criteria (articles available in full, in Portuguese, published between 2011 and 2015), there were 49 productions, and 16 were selected. Analyzing the sample for the event characteristics, it was observed a higher incidence of accidents in males. The main causes of burns were heated by liquid, followed by direct flame. Regarding the classification, the most frequent injury was the 2nd degree, but also there were burns reports with mixed classification. Also, the upper limbs and trunk were the body parts most affected. In addition to these data, it was also highlighted the most frequent types of systemic changes caused by burns, which were respiratory complications, infection and/or sepsis and metabolic sequels.  Conclusion: The study showed the need to characterize of the publications in burns, since the crossing of this information provides a better understanding of the main causal factors, distribution and identification of risk groups. It also enables the planning of prevention strategies to help to reduce accidents, favoring the reduction of injuries and the number of hospitalizations. Moreover, it is extremely important that health professionals know about the epidemiological profile, to provide support in the evaluation and organization of care, and to prevention campaigns, aiming to decrease burn rates. Keywords: Profile; Burns; Burn Units