Abstract Paper aims The aim was to adapt and apply a SERVQUAL scale to measure the perceived service quality of an e-learning platform provided by the United Nations for Environment Programme (UNEP) focused on sustainability issues. Originality There is a scarce number of publications using the SERVQUAL for digital services evaluation. This study contributes to filling this gap, generating new insights for the service quality literature by proposing an adaptation of the SERVQUAL scale for online sustainability courses. Research method The SERVQUAL was carried out with undergraduate and post-graduate students enrolled at a Brazilian higher education institution. A set of 21 questions was set up to evaluate the perceived service quality of the students before/after finishing the online course “Introduction to Life Cycle Thinking (LCT)” provided by UNEP. Main findings The results showed that the most important features were related to the empathy, assurance and tangibility quality dimensions with emphasis on the high quality of addressing the user doubts and the audio and video resources that helped students in the learning process. In conclusion, the perceived quality was higher than the expectations for many of the SERVQUAL dimensions. Implications for theory and practice Finally, the step-by-step methodological approach used by this paper should be adopted by other e-learning platforms to investigate quality and service management aspects. Empathy, assurance and tangibility may be seen as key components in the service quality management of e-learning platforms.

RESUMO Objetivo: avaliar a incidência, características epidemiológicas, diagnóstico e evolução dos pacientes que retornaram às unidades de pronto atendimento (UPA) do Hospital Albert Einstein em São Paulo/SP com sinais e sintomas sugestivos de complicações até 30 dias após realização de colonoscopia. Métodos: estudo retrospectivo uni-institucional de pacientes submetidos à colonoscopia em 2014 e que retornaram, em até 30 dias após o procedimento, a uma UPA. Resultados: foram realizadas colonoscopias em 8968 pacientes, dos quais 95 (1,06%) tiveram queixa relacionada à possível complicação. A maioria dos procedimentos foi realizada eletivamente. Complicações menores (dor abdominal inespecífica/distensão) foram frequentes (0,49%) e a maioria dos pacientes recebeu alta após consulta na UPA. Complicações graves foram menos frequentes: perfuração (0,033%), hemorragia digestiva baixa (0,044%) e obstrução intestinal (0,044%). A procura à UPA em menos de 24 horas após o procedimento associou-se a maior índice de colonoscopias normais (P=0,006), mais diagnóstico de febre (P=0,0003) e síndrome dispéptica (P=0,043) e menos diagnóstico de colite/ileíte (P=0,015). A presença de febre em pacientes atendidos na UPA associou-se ao diagnóstico de pólipos na colonoscopia (P=0,030). Conclusão: os dados do presente estudo corroboram as evidências de segurança do exame de colonoscopia e apontam para redução nos índices de complicações mais graves deste exame.

ABSTRACT Objective: to evaluate the incidence, epidemiological characteristics, diagnosis and evolution of patients who returned to the emergency care units of the Albert Einstein Hospital in São Paulo/SP with signs and symptoms suggestive of colonoscopy complications up to 30 days after the procedure. Methods: we conducted a retrospective, uni-institutional study of patients submitted to colonoscopy in 2014 who returned to the Emergency department (ED) within 30 days after the procedure. Results: 8968 patients underwent colonoscopies, 95 (1.06%) of whom had complaints related to possible complications. Most of the procedures were elective ones. Minor complications (nonspecific abdominal pain/distension) were frequent (0.49%) and most of the patients were discharged after consultation at the ED. Severe complications were less frequent: perforation (0.033%), lower gastrointestinal bleeding (0.044%), and intestinal obstruction (0.044%). ED consultations in less than 24 hours after the procedure was associated with a higher index of normal colonoscopies (p=0.006), more diagnosis of fever (p=0.0003) and dyspeptic syndrome (p=0.043), and less diagnosis of colitis/ileitis (p=0.015). The observation of fever in patients treated at the ED was associated with the diagnosis of polyps at colonoscopy (p=0.030). Conclusion: the data corroborate the safety of the colonoscopy exam and points to a reduction in major complications rates.

O estresse é um dos fatores que está relacionado com o desenvolvimento de doenças dentre elas, as dermatoses, podendo impactar a qualidade de vida. O estudo teve por objetivo avaliar aspectos biopsicossociais, e qualidade de vida de pessoas com dermatoses crônicas atendidas em centro de saúde de dermatologia. Trata-se de delineamento transversal analítico. Os participantes foram 130 adultos com diagnóstico de dermatoses crônicas como vitiligo e psoríase. Foram utilizados instrumentos como o questionário de dados sociodemográficos e da situação clínica; e índice de qualidade de vida em dermatologia DLQI-BRA. O estudo foi aprovado pelo Comitê de Ética de Pesquisa do Unilasalle/Canoas/RS. Foram realizadas análise descritiva no programa estatístico SPSS 20.0. Dentre os resultados obtidos sobre a caracterização da amostra estão: 66,4% do sexo feminino, 51 anos a média de idade, 49,6% vivem juntos, 82,4% têm filhos e 61% tem até o ensino fundamental completo. Dentre a situação clínica a maior prevalência foi de 34,6% com a dermatose crônica psoríase. Dos participantes 67,2% referiram ter tido situação de estresse no último ano, 47,4% consideram a sua saúde como boa ou muito boa, 62,6% a sua qualidade de vida boa e muito boa e 87,8% referem que tem apoio emocional. O instrumento DLQI-BRA apresentou cronbach´s alpha 0,83. Esta investigação contribui para a avaliação dos aspectos biopsicossociais implicados na qualidade de vida de pessoas com dermatoses crônicas.

Stress is a factor that is related to the development of diseases among them, dermatoses and may impact the quality of life. The study aimed to assess biopsychosocial aspects and quality of life of people with chronic dermatoses treated at health center dermatology. It is an analytical cross-sectional design. Participants were 130 adults with a diagnosis of chronic skin diseases such as psoriasis and vitiligo. Instruments such as sociodemographic questionnaire and clinical status were used; index and quality of life in dermatology DLQI-BRA. The study was approved by the Ethics Committee for Research on Unilasalle / Canoas / RS. Descriptive analyzes were performed using SPSS 20.0 statistical software. Among the results on the characterization of the sample are: 66.4% female, average 51 years old, 49.6% are living together, 82.4% have children and 61% have even finished elementary school. Among the clinical situation the highest prevalence was 34.6% with chronic skin psoriasis. 67.2% of participants reported having a stress situation in the last year, 47.4% consider their health as good or very good, 62.6% its good and very good life quality and 87.8% reported that have emotional support. The instrument DLQI-BRA presented cronbach's alpha 0.83. This research contributes to the assessment of the biopsychosocial aspects involved in the quality of life of people with chronic dermatoses.

Introdução O uso de ventilação não invasiva sob a forma de Continuous Positive Airway Pressure (CPAP) está entre as principais opções terapêuticas no manejo de pacientes com apneia obstrutiva do sono (AOS). No entanto, os efeitos obtidos logo na primeira noite de uso do CPAP ainda são pouco relatados. Objetivo Avaliar os efeitos agudos do CPAP sobre variáveis polissonográficas em pacientes com AOS. Materiais e métodos Trata-se de uma série de casos, com um total de 31 pacientes (55,8 ± 11,4 anos; 22 homens) em fase inicial de tratamento com o CPAP no Instituto do Sono de Santa Maria (RS). Os sujeitos foram avaliados pela polissonografia sem e com CPAP (10,2 ± 3,1 cmH2O), em dias diferentes, por meio das seguintes variáveis: estágios do sono 1, 2 e 3 (N1, N2 e N3), sono REM (rapid eyes moviment), índice de apneia e hipopneia (IAH), IAH no sono REM (IAHREM) e índice de microdespertares (IMD). Resultados Houve diminuição com o uso do CPAP no N2 (p < 0,001), IAH (p < 0,001), IAHREM (p < 0,001) e IMD (p = 0,001). O N3 (p = 0,006) e o sono REM (p < 0,001) aumentaram durante a noite com o CPAP. Conclusão Este estudo demonstrou que o CPAP, logo na primeira noite de sua utilização, promove um maior equilíbrio entre as fases e melhora na qualidade do sono de pacientes com AOS. Esses resultados devem ser apresentados aos pacientes e aos seus familiares, visando estimular maior adesão na fase inicial do tratamento com o CPAP.

Introduction The use of non-invasive ventilation in the form of continuous positive airway pressure (CPAP) is among the main therapeutic options for patients with obstructive sleep apnea (OSA). Yet the effects of CPAP obtained on the first night of use are underreported. Objective To evaluate the acute effects of CPAP on polysomnographic variables in patients with OSA. Materials and methods This study is a case series with 31 patients (55.8 ± 11.4 years; 22 men) in the initial phase of CPAP treatment. The subjects were evaluated by means of polysomnography with and without CPAP (10.2 ± 3.1 cmH2O) and without CPAP, on different days, by means of the following variables: sleep stages 1, 2 and 3 (N1, N2 and N3), rapid eye movement (REM) sleep, apnea and hypopnea index (AHI), AHI in REM sleep (AHIREM) and the micro-arousal index (MAI). Results The use of CPAP resulted in a reduction of N2 (p < 0.001), AHI (p < 0.001), AHIREM (p < 0.001) and MAI (p = 0.001). There was an increase in N3 (p = 0.006) and REM sleep (p < 0.001) during the night with use of CPAP. Conclusion This study demonstrated that, from the first night of use by patients with OSA, CPAP promotes greater balance between sleep phases, and improves sleep quality. These results should be presented to patients and their families in order to encourage greater adherence in the initial phase of treatment with CPAP.