Incidência e fatores associados à contenção física em pacientes agitados e/ou agressivos em emergências psiquiátricas

Os pacientes agressivos e/ou agitados correspondem a 10% de todas as internações em emergências psiquiátricas. Dependendo do grau de agitação, esses pacientes representam um risco para a integridade física, tanto para os profissionais que ali estão como para si mesmos. Dentre as alternativas para lidar com esses casos está a contenção física. Ainda que amplamente utilizada, seu uso é controverso e proibido em alguns países. No Brasil inexistem protocolos orientando o seu uso. O objetivo deste estudo foi conhecer a freqüência e os fatores associados a esta prática através de uma revisão sistemática e de um estudo em emergências psiquiátricas do município do Rio de Janeiro. A revisão identificou apenas quatro estudos, sendo três nos EUA e um na Índia. A freqüência de contenção em pacientes agitados e/ou agressivos nos serviços de emergência psiquiátrica variou de 14% até 59%. Os desenhos adotados, assim como as análises estatísticas, mostraram fragilidades para a investigação dos fatores explicativos para o uso de contenção física. O estudo nas emergências psiquiátricas do Rio de Janeiro lançou mão de informações sobre o uso de contenção física entre 298 pacientes participantes de um ensaio clínico comparando dois medicamentos para lidar com quadros de agitação psicomotora e comportamento agressivo nesses serviços. As variáveis investigadas foram aquelas coletadas antes da entrada do paciente no ensaio clínico. Portanto, variáveis que antecederam a decisão do médico conter o paciente. A análise dos dados fez uso do método Bayesiano. As prioris dos parâmetros utilizadas no modelo de regressão binária foram obtidas de um outro ensaio clínico, conduzido em uma das três emergências envolvidas no presente estudo. A freqüência no emprego da contenção física foi 24,5%, sem diferença entre os três hospitais. O estudo mostrou ainda que pacientes mais jovens, com quadros mais intensos, com suspeita diagnóstica de entrada de abuso de substâncias e que foram atendidos na parte da manhã apresentaram maior chance de serem fisicamente contidos. O presente trabalho aponta para a necessidade de conduzir estudos especificamente desenhados para avaliar a freqüência e os fatores associados com o uso de contenção física, os quais deverão subsidiar o desenvolvimento de protocolos sobre o uso desta prática em nosso meio.

Geotecnologias e recursos de multimídia no ensino de cartografia: percepção sócio ambiental do rio Alcântara no município de São Gonçalo/RJ

A disponibilidade gratuita na Internet de imagens de satélite e SIG somada à facilidade dos alunos no manuseio de multimídia através dos seus smartphones criam possibilidades para trabalhar com geotecnologias e recursos de multimídia no ensino de Cartografia. Nesta pesquisa foram avaliadas as contribuições, os limites e as possibilidades da inserção da tecnologia espacial, geoprocessamento e recursos de multimídia nas aulas de Geografia do sétimo ano da rede pública municipal de São Gonçalo/RJ; foi desenvolvida uma metodologia em meio digital, por meio da Internet, denominada Mapeando Meu Rio (MMR) cuja temática abordada foi a Percepção Socioambiental do Rio Alcântara. Observaram-se o interesse e o envolvimento dos alunos no decorrer das atividades propostas, por meio do uso de recursos de multimídia e geotecnologias como materiais de apoio à Educação Ambiental. Os resultados da avaliação do MMR mostraram que os alunos chegaram ao final do sétimo ano com dificuldades em relação à alfabetização cartográfica; isso foi constatado tanto na produção dos mapas mentais como também pela utilização do GPS, Google Earth e do ArcGIS Online. Os alunos tiveram dificuldades em utilizar os conhecimentos básicos da Cartografia para elaborar uma representação espacial, mais especificamente, legenda, coordenadas geográficas e orientação espacial. A alfabetização cartográfica não deve ser considerada como conteúdo que se restringe ao 6 ano, mas uma linguagem de comunicação para o entendimento da dinâmica espacial no decorrer do Ensino Fundamental e do Ensino Médio. As atividades geográficas deve permitir ao aluno melhorar a compreensão do espaço geográfico de uma maneira mais significativa para construir abstrações a partir da própria realidade, ou seja, do espaço vivido.

A posse do art. 1276 do CC como forma de aquisição da propriedade imóvel

De inegável relevância na vida humana, a posse se configura como um dos temas mais controvertidos no âmbito do Direito Civil. Em todos os seus contornos e características, incluindo sua natureza jurídica, terminologia, efeitos e classificações, observamos um debate acirrado e polêmico a seu respeito, o que demonstra o firme interesse dos estudiosos sobre a possessio através dos séculos. Ademais, compete ao aplicador do Direito compreender o fenômeno possessório a partir das premissas e valores constitucionais fundamentais, em especial o princípio da dignidade da pessoa humana, levando em consideração as mutações sociais e a realidade dos fatos, para que seja possível extrair do ordenamento caminhos efetivos à concretização de uma sociedade justa e solidária, a fim de erradicar a pobreza e diminuir as desigualdades sociais. Neste contexto, de forma prospectiva e adequando os conceitos civilistas à Carta da República, defendemos a aplicação do artigo 1276 do Código Civil também em benefício do ocupante qualificado de imóvel abandonado, de modo a consolidar o domínio em seu favor no mesmo triênio conferido à Administração Pública, garantindo-se então aos menos favorecidos o legítimo acesso à moradia e ao trabalho. Na medida em que o ser humano se constitui no foco de atenção, preocupação e proteção do ordenamento jurídico acreditamos que as exegeses normativas devem concretizar o disposto no artigo 1, inciso III, da Constituição da República, razão pela qual a posse de outrem exercida ininterruptamente sobre bem abandonado merece funcionar como forma de aquisição originária da propriedade imóvel privada no lapso de tempo estatuído no artigo 1276 do Código Civil.

A regularização fundiária e o registro de imóveis

Este trabalho tem por finalidade apresentar um estudo sobre as contribuições do serviço de registro imobiliário, com destaque em procedimentos de regularização fundiária de imóveis urbanos. Não raras vezes, empreendedores, administradores públicos, juízes, sociedade deparam-se com situações em que há a necessidade de titulação da terra como mecanismo de formalização da propriedade, oportunidade em que são exigidos os requisitos estabelecidos na legislação de regência. A adoção em caráter estrito das regras estabelecidas, em contraposição às peculiaridades e ao desregramento de assentamentos informais, importaria em eterna manutenção dos mesmos à margem da lei. Há, assim, de se criar mecanismos de consenso e soluções de compromisso, em que poder público, registrador imobiliário, operadores do direito e a própria comunidade envolvam-se no sentido de colmatar uma solução intermediária. Solução esta que, sem perder a necessária segurança jurídica dos registros públicos, possibilite a adoção de mecanismos que facilitem o acesso dos ocupantes à titulação da terra em que vivem. O título de propriedade representa mais do que mero papel. Traduz o poder de direito sobre determinado terreno, alçando-o da condição de um capital morto para elemento ativo em um mercado cada dia mais globalizado. Nesta esteira, arregimenta economicamente não apenas a população diretamente envolvida, quanto também possibilita, através da inserção dos imóveis regularizados no mercado, um aproveitamento e um incremento econômico catalisador de transformações econômico-sociais. Novos direitos, novos bens em garantia, novas condições de crédito, renovada segurança jurídica, enfim, novas oportunidades são desdobradas aos detentores, que agora podem investir sem o receio da precariedade decorrente de mera situação de posse. Estuda-se, assim, neste trabalho a importante atuação do registrador imobiliário e as vantagens decorrentes do processo de regularização fundiária, como um processo a ser estimulado e incrementado, concretizador de cidadania e efetivador dos direitos fundamentais de propriedade (art 5 CF/88) e de moradia (art. 6 da CF/88).

Aquatic ecology monitoring: water quality, fish, fish catch, sanitation and disease vectors: monitoring no. 10 and reservoir baseline, 23rd – 30th April 2012

The results reported on were from a monitoring survey No. 10 undertaken between 23 rd and 29th April 2012 during construction period of the Bujagali Hydropower Project (BHPP). Two pre-construction, baseline surveys in April 2000 and April 2006 were conducted and so far, during construction phase of the project, nine monitoring surveys have been undertaken i.e. in September 2007, April 2008, April 2009, October 2009, April 2010, September 2010, April 2011, September 2011and the present one, in April 2012. Since 2009 biannual monitoring surveys have been conducted at an upstream and a downstream transect of the BHPP with emphasis on the following aspects: water quality determinants biology and ecology of fishes and food webs fish stock and fish catch including economic aspects of catch and sanitation/vector studies (bilharzias and river blindness) During this survey, baseline assessment of the above mentioned studies was conducted in the reservoir behind the dam, including studies on algae, zooplankton and benthic macroinvertebrates which had been restrained since April 2008. The findings of baseline assessment of the reservoir are also contained in this report and are compared with those obtained from Transect 1(Upstream) and Transect 2 (Downstream).

Aquatic ecology monitoring: water quality, fish, fish catch, sanitation and disease vectors: monitoring no.12, 25th-30th April 2013

Bujagali hydropower dam construction is now completed and a reservoir behind the dam has been created, extending all the way up to Kalange-Makwanzi, an upstream transects. During the 10th monitoring survey-April 2012, a third transect was established in the mid of the reservoir where it runs up to 30 m deep and sampled similarly as at the two original sampling transects, Kalange-Makwanzi and Buyala-Kikubamutwe for comparative purposes. This monitoring survey No. 12 undertaken between 25th and 30th April 2013 is the third one to be conducted after completion of construction of Bujagali Hydropower Dam. Two pre-construction baseline surveys in April 2000 and April 2006 were conducted and during construction phase, eight monitoring surveys (September 2007, April 2008, April 2009, October 2009, April 2010, September 2010, April 2011, September 2011) were conducted. Since 2009 biannual monitoring surveys have been conducted at an upstream and a downstream transect of the BHPP with emphasis on the following aspects: water quality determinants, biology and ecology of fishes and food webs, fish stock and fish catch including economic aspects of catch and sanitation/vector studies (bilharzias and river blindness). In the post-construction monitoring surveys, the assessments of algae, zooplankton and benthic macro-invertebrates which had been restrained since April 2008 were also included.

Dynamic characterisation and longitudinal strength of swaged joints

Swaging is a cold working process involving plastic deformation of the work piece to change its shape. A swaged joint is a connection between two components whereby a swaging tool induces plastic deformation of the components at their junction to effectively bind them together. This is commonly used when welding or other standard joining techniques are not viable. Swaged joints can be found for example, in nuclear fuel assemblies to connect the edges of thin rectangular plates to a supporting structure or frame. The aim of this work is to find a model to describe the vibrational behaviour of a swaged joint and to estimate its strength in resisting a longitudinally applied load. The finite element method and various experimental rigs were used in order to find relationships between the natural frequencies of the plate, the joint stiffness and the force required to shift the plate against the restraining action of the swage connection. It is found that a swaged joint is dynamically equivalent to a simple support with the rotation elastically restrained and a small stiffness is enough to resist an important load. © 2011 Elsevier Ltd. All rights reserved.

Parameters identification by a single point free response measurement

When a thin rectangular plate is restrained on the two long edges and free on the remaining edges, the equivalent stiffness of the restraining joints can be identified by the order of the natural frequencies obtained using the free response of the plate at a single location. This work presents a method to identify the equivalent stiffness of the restraining joints, being represented as simply supporting the plate but elastically restraining it in rotation. An integral transform is used to map the autospectrum of the free response from the frequency domain to the stiffness domain in order to identify the equivalent torsional stiffness of the restrained edges of the plate and also the order of natural frequencies. The kernel of the integral transform is built interpolating data from a finite element model of the plate. The method introduced in this paper can also be applied to plates or shells with different shapes and boundary conditions. © 2011 Elsevier Ltd. All rights reserved.

Automated Detection of Exposed Reinforcement in Post-Earthquake Safety and Structural Evaluations

Post-earthquake structural safety evaluations are currently performed manually by a team of certified inspectors and/or structural engineers. This process is time-consuming and costly, keeping owners and occupants from returning to their businesses and homes. Automating these evaluations would enable faster, and potentially more consistent, relief and response processes. In order to do this, the detection of exposed reinforcing steel is of utmost significance. This paper presents a novel method of detecting exposed reinforcement in concrete columns for the purpose of advancing practices of structural and safety evaluation of buildings after earthquakes. Under this method, the binary image of the reinforcing area is first isolated using a state-of-the-art adaptive thresholding technique. Next, the ribbed regions of the reinforcement are detected by way of binary template matching. Finally, vertical and horizontal profiling are applied to the processed image in order to filter out any superfluous pixels and take into consideration the size of reinforcement bars in relation to that of the structural element within which they reside. The final result is the combined binary image disclosing only the regions containing rebar overlaid on top of the original image. The method is tested on a set of images from the January 2010 earthquake in Haiti. Preliminary test results convey that most exposed reinforcement could be properly detected in images of moderately-to-severely damaged concrete columns.

Closing the Energy Efficiency Gap: A study linking demographics with barriers to adopting energy efficiency measures in the home

This paper presents a study which linked demographic variables with barriers affecting the adoption of domestic energy efficiency measures in large UK cities. The aim was to better understand the 'Energy Efficiency Gap' and improve the effectiveness of future energy efficiency initiatives. The data for this study was collected from 198 general population interviews (1.5-10 min) carried out across multiple locations in Manchester and Cardiff. The demographic variables were statistically linked to the identified barriers using a modified chi-square test of association (first order Rao-Scott corrected to compensate for multiple response data), and the effect size was estimated with an odds-ratio test. The results revealed that strong associations exist between demographics and barriers, specifically for the following variables: sex; marital status; education level; type of dwelling; number of occupants in household; residence (rent/own); and location (Manchester/Cardiff). The results and recommendations were aimed at city policy makers, local councils, and members of the construction/retrofit industry who are all working to improve the energy efficiency of the domestic built environment. © 2012 Elsevier Ltd.

Transducer and base compliance alter the in situ 6 dof force measured from muscle during an isometric contraction in a multi-joint limb.

Although musculoskeletal models are commonly used, validating the muscle actions predicted by such models is often difficult. In situ isometric measurements are a possible solution. The base of the skeleton is immobilized and the endpoint of the limb is rigidly attached to a 6-axis force transducer. Individual muscles are stimulated and the resulting forces and moments recorded. Such analyses generally assume idealized conditions. In this study we have developed an analysis taking into account the compliances due to imperfect fixation of the skeleton, imperfect attachment of the force transducer, and extra degrees of freedom (dof) in the joints that sometimes become necessary in fixed end contractions. We use simulations of the rat hindlimb to illustrate the consequences of such compliances. We show that when the limb is overconstrained, i.e., when there are fewer dof within the limb than are restrained by the skeletal fixation, the compliances of the skeletal fixation and of the transducer attachment can significantly affect measured forces and moments. When the limb dofs and restrained dofs are matched, however, the measured forces and moments are independent of these compliances. We also show that this framework can be used to model limb dofs, so that rather than simply omitting dofs in which a limb does not move (e.g., abduction at the knee), the limited motion of the limb in these dofs can be more realistically modeled as a very low compliance. Finally, we discuss the practical implications of these results to experimental measurements of muscle actions.

Energy performance certification as a signal of workplace quality

Energy performance labelling and certification have been introduced widely to address market failures affecting the uptake of energy efficient technologies, by providing a signal to support decision making during contracting processes. The UK has recently introduced the Energy Performance Certificate (EPC) as a signal of building energy performance. The aims of this article are: to evaluate how valid EPC's are signals of occupier satisfaction with office facilities; and to understand whether occupant attitudes towards environmental issues have affected commercial office rental values. This was achieved by surveying occupant satisfaction with their workplaces holistically using a novel multi-item rating scale which gathered 204 responses. Responses to this satisfaction scale were matched with the corresponding EPC and rental value of occupier's workplaces. The satisfaction scale was found to be both a reliable and valid measure. The analysis found that EPC asset rating correlates significantly with occupant satisfaction with all facility attributes. Therefore, EPC ratings may be considered valid signals of overall facility satisfaction within the survey sample. Rental value was found to correlate significantly only with facility aesthetics. No evidence suggests rental value has been affected by occupants' perceptions towards the environmental impact of facilities. © 2013 The Authors.

A simplified mathematical approach for modelling stack ventilation in multi-compartment buildings

A simple mathematical model of stack ventilation flows in multi-compartment buildings is developed with a view to providing an intuitive understanding of the physical processes governing the movement of air and heat through naturally ventilated buildings. Rules of thumb for preliminary design can be ascertained from a qualitative examination of the governing equations of flow, which elucidate the relationships between 'core' variables - flow rates, air temperatures, heat inputs and building geometry. The model is applied to an example three-storey office building with an inlet plenum and atrium. An examination of the governing equations of flow is used to predict the behaviour of steady flows and to provide a number of preliminary design suggestions. It is shown that control of ventilation flows must be shared between all ventilation openings within the building in order to minimise the disparity in flow rates between storeys, and ensure adequate fresh air supply rates for all occupants. © 2013 Elsevier Ltd.

Stack ventilation in multi-storey atrium buildings: A dimensionless design approach

Using a simplified mathematical model, a preliminary design strategy for steady stack ventilation in multi-storey atrium buildings is developed. By non-dimensionalising the governing equations of flow, two key dimensionless parameters are identified - a ventilation performance indicator, λ, and atrium enhancement parameter, E - which quantify the performance of the ventilation system and the effectiveness of the atrium in assisting flows. Analytical expressions are determined to inform the vent sizes needed to provide the desired balance between indoor air temperature, ventilation flow rate and heat inputs for any distribution of occupants within the building, and also to ensure unidirectional flow. Dimensionless charts for determining the required combination of design variables are presented with a view to informing first-order design guidance for naturally ventilated buildings. © 2013 Elsevier Ltd.

EFFECTS OF IRON ON PHYSIOLOGICAL AND BIOCHEMICAL CHARACTERISTICS OF Microcystis wesenbergii (Kom.) Kom. (Cyanobacterium)

Iron is an essential trace element for biological requirements of phytoplankton. Effects of iron on physiological and biochemical characteristics of Microcystis wesenbergii were conducted in this study. Results showed that 0.01 mu M [Fe3+] seriously inhibited growth and chlorophyll synthesis of M. wesenbergii, and induced temporary increase of ATPase activities, however, NR. ACP and ALP activities were restrained by iron limitation. Interestingly, iron addition on day 8 resulted in the gradual restoration of structures and functions of above enzymes and resisted a variety of stresses from iron limitation. M. wesenbergii in 10 mu M [Fe3+] treatment group grew normally. enzymes maintained normal levels, and residual phosphate contents in cultures first sharply decreased, then smoothly as M. wesenbergii has a characteristic of luxury consumption of phosphorus. Above parameters in 100 mu M [Fe3+] treatment group were almost same with those in 10 mu M [Fe3+] treatment group except for NR, ACP and ALP activities. In 100 mu M [Fe3+] treatment group, activities of ACP and ALP had temporary increase because phosphate and ferric iron could form insoluble compound - ferric phosphate (Fe3PO4) through adsorption effect. resulting in lack of bioavailable phosphate in culture media. The experiment suggested that too low or too high iron can affect obviously physiological and biochemical characteristics of M. wesenbergii.