ABSTRACT
RESUMO A exploração indiscriminada de água subterrânea pode causar o colapso dos aquíferos costeiros. Nesse escopo, este trabalho avaliou o comportamento da cunha salina em parte do sistema Barreiras/Marituba, que fica na costa da região metropolitana de Maceió (AL), fazendo uso de modelagem e índices hidrogeoquímicos. O modelo foi calibrado tanto para o fluxo subterrâneo como para a concentração de sólidos totais dissolvidos, nos quais atingiu coeficiente de correlação de 0,764 e 0,682, respectivamente. Foram analisados dois cenários distintos, que permitiram verificar o efeito da explotação de água subterrânea na cunha salina para uma projeção de dez anos. O primeiro considerou a explotação existente até 2015, sem acréscimos de bombeamentos. Como resultado, verificou-se o avanço da cunha salina em duas áreas do domínio e outra área sofreu recuo, além da formação de cones com ascensão vertical da água do mar. No segundo cenário, foram adicionadas, além das licenças de obras hídricas já existentes, como poços, a hipótese de instalação de 36 novos poços de bombeamento, considerando o crescimento da cidade. Porém, nesse caso, não foi possível visualizar variações significativas na zona de mescla em relação ao primeiro cenário. A análise dos índices hidrogeoquímicos apontou para maiores concentrações de cloretos na região próxima à linha do Oceano Atlântico, com pouca influência do nitrato e, no geral, indicou a existência de intrusão de água do mar.
ABSTRACT The groundwater overexploitation can cause the collapse of coastal aquifers. In this scope, this study evaluated the behavior of the salt wedge in part of the Barreiras/Marituba system aquifer present on the coast of the Metropolitan Region of Maceió, Alagoas, using hydrogeochemical modeling and indexes. The model was calibrated for both the underground flow and the total dissolved solids concentration, obtaining a correlation coefficient of 0.764 and 0.682, respectively. Two different scenarios were analyzed, which allowed verifying the effect of the exploitation of groundwater in the salt wedge for a projection of 10 years. The first considered the existing operation until 2015, without any additional pumping. Results shows that saline wedge advanced in two areas of the domain and another site was retreated, in addition to the formation of cones with vertical rise of the sea water. The second scenario, besides the already existing waterworks licenses, was also added by the installation of 36 hypothetical pumping wells, based in the city growth. However, in this case, it was not possible to visualize significant variations in the melting zone in relation to the first scenario. The analysis of hydrogeochemical indices shows to higher concentrations of chlorides in the region near the Atlantic Ocean line, with little influence of nitrate and, in general, indicated the existence of sea water intrusion.
ABSTRACT
Introducción. La evaluación de la calidad de vida relacionada con la salud (CVRS) permite detectar cambios en el tiempo en la salud de pacientes y posibilita realizar un análisis de coste-efectividad de tratamientos. En niños con características especiales de salud que no pueden autoevaluarse, existe la posibilidad de evaluar su CVRS a través de padres o cuidadores. Hasta la fecha, no se ha analizado la discrepancia en la evaluación de la CVRS a través del cuestionario EQ-5D-Y entre niños con parálisis cerebral (PC) y sus padres. El objetivo del presente estudio fue analizar el grado de concordancia en la evaluación de la CVRS a través del cuestionario EQ-5D-Y y su versión Proxy entre niños con PC y sus padres o cuidadores. Población y métodos. Participaron, en el estudio, niños y adolescentes con PC, así como sus padres y madres, procedentes de un centro de educación especial de la región de Extremadura (España). Se utilizó el cuestionario EQ-5D-Y para los niños y el EQ-5D-Y Proxy para los padres. Las entrevistas fueron llevabas a cabo durante el primer trimestre de 2015. Se analizó la concordancia en las respuestas mediante el nivel de acuerdo con kappa de Cohen para las 5 dimensiones que componen el EQ-5D-Y y el coeficiente de correlación intraclase para la escala visual analógica. Resultados. Participaron 62 niños con PC con afectación leve y/o moderada de su capacidad funcional, sus padres y madres. Hubo una pobre concordancia en la evaluación de la CVRS entre niños y padres en todas las dimensiones del cuestionario (< 0, 20) y justo o pobre (< 0, 60) en la escala visual analógica. Conclusiones. Existe un alto desacuerdo en la evaluación de la CVRS entre padres e hijos en población con PC a través del cuestionario EQ-5D-Y.
Introduction. The assessment of health-related quality of life (HRQoL) serves to detect changes over time in patients' health status and allows to do a cost-effectiveness analysis of treatments. When children with special health features cannot perform a self-assessment, it is possible to assess their HRQoL through their parents or caregivers. To date, the discrepancy in the assessment of HRQoL using the EQ-5D-Y questionnaire among children with cerebral palsy (CP) and their parents has not been analyzed. The objective of this study was to analyze the level of agreement in the HRQoL assessment using the EQ-5D-Y questionnaire and its proxy version among children with CP and their parents or caregivers. Population and methods. Children and adolescents with CP, and their parents, from a special education school in the region of Extremadura (Spain) participated in the study. The EQ-5D-Y questionnaire was used for children and the EQ-5D-Y proxy version, for parents. Interviews were conducted in the first quarter of 2015. The level of agreement in the responses was analyzed using the Cohen's kappa coefficient for the five domains of the EQ-5D-Y and the intraclass correlation coefficient for the visual analogue scale. Results. Sixty-two children with CP and mild and/or moderate functional capacity impairment, and their parents, participated in the study. The level of agreement was poor in the HRQoL assessment between children and parents in all the questionnaire domains (<0.20) and fair or poor (<0.60) in the visual analogue scale. Conclusions. A high level of parent-child disagreement was observed in the HRQoL assessment in the population with CP using the EQ-5D-Y questionnaire.