Current practices in managing acutely disturbed patients at three hospitals in Rio de Janeiro-Brazil: a prevalence study

The medical management of aggressive and violent behaviour is a critical situation for which there is little evidence. In order to prepare for a randomised trial, due to start in the psychiatric emergency rooms of Rio de Janeiro in 2001, a survey of current practice was necessary. A seven day survey of pharmacological management of aggressive people with psychosis in the emergency rooms of all four public psychiatric hospitals in Rio de Janeiro, Brazil. In one hospital data were not available. Of the 764 people with psychosis attending these ERs, 74 were given IM medication for rapid tranquillisation (9.7%, 2.1/week/100,000). A haloperidol-promethazine mix (with or without other drugs) was used for the majority of patients (83%). The haloperidol-promethazine mix, given intramuscularly for rapid tranquilization, is prevalent in Rio, where it is considered both safe and efficient. However, scientific evaluation of all pharmacological approaches to rapid tranquilization of psychotic people is inadequate or incomplete and a randomized trial of IM haloperidol-promethazine is overdue

Current practices in managing acutely disturbed patients at three hospitals in Rio de Janeiro-Brazil: a prevalence study

BACKGROUND: The medical management of aggressive and violent behaviour is a critical situation for which there is little evidence. In order to prepare for a randomised trial, due to start in the psychiatric emergency rooms of Rio de Janeiro in 2001, a survey of current practice was necessary. METHODS: A seven day survey of pharmacological management of aggressive people with psychosis in the emergency rooms of all four public psychiatric hospitals in Rio de Janeiro, Brazil. RESULTS: In one hospital data were not available. Of the 764 people with psychosis attending these ERs, 74 were given IM medication for rapid tranquillisation (9.7%, 2.1/week/100,000). A haloperidol-promethazine mix (with or without other drugs) was used for the majority of patients (83%). CONCLUSION: The haloperidol-promethazine mix, given intramuscularly for rapid tranquilization, is prevalent in Rio, where it is considered both safe and efficient. However, scientific evaluation of all pharmacological approaches to rapid tranquilization of psychotic people is inadequate or incomplete and a randomized trial of IM haloperidol-promethazine is overdue

NESTOR: A neutrino particle astrophysics underwater laboratory for the Mediterranean

Abstract An underwater neutrino astrophysics laboratory, to be located in the international waters off the Southwest of Greece, near the town of Pylos is now under construction. In the last two years a group of physicists from Greece and Russia have carried out two demonstration experiments in 4km deep water, counting muons and verifying the adequacy of the deep sea site. Plans are presented for a 100, 000 m 2 high energy neutrino detector composed of a hexagon of hexagonal towers, with 1176 optical detector units. A progress report is given and the physics potential of a siggle tower with 168 phototubes (currently under construction) is described

Valence and transitivity in Saliba, an Oceanic language of Papua New Guinea

Contains fulltext : 145661.pdf (Publisher’s version ) (Open Access)364 p

Hazard assessment investigations in connection with the formation of a lake on the tongue of Unterer Grindelwaldgletscher, Bernese Alps, Switzerland

The surface of Unterer Grindelwaldgletscher glacier tongue has subsided by more than 200 m over the last 150 years. The surface lowering is not uniform over the glacier tongue but depends on the thickness of the uneven debris cover, which led to the formation of a depression on the tongue. A lake can form in this basin, which occurred for the first time in 2005. Such a glacier lake can drain rapidly leading to a so-called outburst flood. The lake basin has been increasing in size at an alarming rate and in 2008, it reached a volume which poses a significant flooding threat to the communities downstream, as was exemplified by an outburst of the lake in May 2008. The future evolution of the lake basin was extrapolated based on surface lowering rates between 2004–2008. An outburst flood model was tuned with the measured hydrograph from 2008 and then was run with the extrapolated lake bathymetries to simulate future lake outbursts and estimate their flood hydrographs. We discuss the rapidly increasing risk for Grindelwald and other communities, as well as the installation of an early warning system and possible prevention measures

Perfil demográfico e sócio-econômico da população de internos dos hospitais psiquiátricos da cidade do Rio de Janeiro Demographic and socioeconomic characteristics of patients from psychiatric hospitals in the city of Rio de Janeiro

O perfil dos pacientes internados em hospitais psiquiátricos, embora fundamental para implementação de mudanças na política assistencial, nem sempre é conhecido. Realizou-se um censo dos pacientes nos vinte hospitais psiquiátricos do Rio de Janeiro. Neste artigo, são apresentadas as características demográficas e sócio-econômicas dos 3.223 pacientes (66,0% homens; 52,6% com idade inferior a 40 anos) em 24 de outubro de 1995. Dentre estes, 73,8% não haviam completado o 1º grau e 25,5% eram analfabetos; 71,6% dos homens e 61,1% das mulheres eram solteiros. Homens e mulheres eram divorciados/separados em igual proporção (13%). À época da primeira internação 43,1% dos pacientes tinham atividade laborativa remunerada. Porém, no momento do censo, apenas metade mantinha essas atividades. Cerca de 50% dos pacientes não recebia visitas ou estas eram esporádicas. Esse dado, juntamente com os fatos de 37,4% estarem internados há mais de um ano e de 65,1% não saírem de licença do hospital, caracteriza uma situação de isolamento. Os resultados do censo são discutidos tendo com base em dados epidemiológicos, e hipóteses são formuladas para explicar alguns desses achados.<br>Knowledge on the characteristics of patients admitted to psychiatric hospitals is essential to adequate care, yet such information is not always available. A survey was conducted on patients in the 20 psychiatric hospitals in the city of Rio de Janeiro, Brazil. This paper presents demographic and socioeconomic data on the study population: 3223 persons (66.0% male; 52.6% under 40) on October 24, 1995. 73.8% had not finished elementary school; 25.5% were illiterate. 71.6% of the males and 61.1% of the females were single. Both groups had the same divorce percentage (13%). 43.1% of patients had jobs at the time of first admission, but only half had kept them by the time of this survey. Some 50% of the patients only received visits at extended intervals or not at all. This finding, plus the fact that 37.4% had been hospitalized for more than one year and 65.1% did not leave the hospital during holidays or weekends, provides a picture of their social isolation. The findings are discussed based on epidemiological data, and hypotheses are suggested to explain some of the results