RESUMEN
Bronchial asthma is a chronic pathology and a global public health problem. However, asthma can be controlled and treated for the most part by patients, so the Portuguese General Directorate of Health recommends shared medical appointments in primary health care (PHC). The present study aims to identify the role of PHC nurses in the control and treatment of asthma in adults. Using the MeSH platform, the following descriptors were validated: asthma, nurses, adults. An individual search was carried out in the following databases: CINAHL (ESBSCO host), MEDLINE (Pubmed host), Web of Science, and Scopus. Out of a total of 280 publications, 79 of which were duplicates and 185 publications which did not meet the inclusion criteria, 16 publications remained readable. Of the eligible articles, there were 13 specialist reports, one mixed study, one quasi-experimental study, and one randomized trial. Education was the intervention most identified in the scientific evidence analyzed, and patient assessment, application of an asthma control questionnaire, verification and training of inhalation technique, empowerment for self-management of the disease, support, promotion of seasonal influenza vaccination, and use of written action plans were also identified. The results reveal that, although the scientific evidence on the intervention of these professionals is poorly developed, nurses play a crucial role in the control and treatment of asthma. The scientific evidence analyzed allowed the identification of interventions that can help the organization of a nursing health appointment, providing nurses with a crucial role in the control and treatment of asthma in adults in the context of PHC.
Asunto(s)
Asma , Rol de la Enfermera , Humanos , Asma/enfermería , Asma/terapia , Adulto , Atención Primaria de SaludRESUMEN
Thermal explosions are often influenced by the complex interaction between transport and reaction phenomena. In particular, reactant consumption can promote safer, non-explosive operation conditions of combustion systems. However, in liquids or gases, the presence of forced convection can affect the behaviour of a system, instigating oscillations in the temperature, reactant concentration and velocity fields. This work describes the effect of reactant consumption on a simple, one-step, exothermic reaction occurring in a spherical reactor with both forced and natural convection, by means of numerical simulations. Regime diagrams characterised by ratios of timescales for each transport and reaction phenomena are presented and the explosion boundary is represented for several forced convection and reaction consumption intensities. Special attention is given to the oscillatory behaviour observed for moderate forced convection and oscillatory regions are represented on the regime diagrams. Parametric conditions for this new oscillatory regime are identified by extending the criticality condition developed by Frank-Kamenetskii for the effect of reactant consumption in diffusive systems to include the effects of both natural and forced convection.
RESUMEN
Explosions may occur as a result of thermal and branching effects in combustion processes. The aim of this work is to study the effects of chain branching and termination in a "Gray and Yang" three-step, chain-thermal reaction scheme, and the role of thermal diffusion and convection in determining the global behaviour. The response includes steady, exothermic combustion, oscillatory reaction and explosion. This was done by solving numerically the governing equations for the underlying kinetics and the heat transport, and analysing solutions for the limits at which each transport phenomenon dominates. Using scales to describe the different transport mechanisms, a 3D regime diagram is used to characterise the behaviour of the system. The results show how branching and heating by reaction enhance the oscillatory and explosive behaviour. The integration of a two-step Sal'nikov reaction scheme and a one-step reaction model in the Gray and Yang scheme is presented and the Frank-Kamenteskii and Semenov limits are identified on the regime diagram. Comparison is made with some experimental, numerical and analytical results.