Avaliação de estratégias para representação e análise do planejamento e controle de obras utilizando modelos BIM 4D

ResumoO objetivo deste artigo é avaliar estratégias para representação e análise do planejamento e controle de obras utilizando Modelos BIM 4D, segundo a visão de profissionais da indústria da construção civil brasileira. A pesquisa envolveu revisão bibliográfica sobre o tema, estudo de caso em um empreendimento com utilização do modelo para planejamento e controle da obra e o desenvolvimento e aplicação de questionário digital para avaliação das potencialidades e estratégias pelos profissionais do setor. O questionário da pesquisa abordou estratégias para representação e análise utilizando cores para diferenciação das atividades internas, alternativas de monitoramento do avanço físico através de simulação dos cronogramas Planejado e Realizado, e visualização deles em tela dividida, além de avaliação sobre adoção de modelos 4D. Os resultados obtidos indicam os graus de importância e aplicabilidade dos aspectos analisados na visão geral dos participantes e estratificados por nível de conhecimento sobre BIM, formação profissional, área de atuação e grau acadêmico

Deliberate termination of life of newborns with spina bifida, a critical reappraisal

Objects: Deliberate termination of life of newborns (involuntary euthanasia) with meningomyelocele (MMC) is practiced openly only in the Netherlands. 'Unbearable and hopeless suffering' is the single most cited criterion for this termination, together with the notion that 'there are no other proper medical means to alleviate this suffering'. In this paper, both (and other) statements are questioned, also by putting them in a broader perspective. Methods: First, a historical overview of the treatment of newborns with MMC is presented, concentrating on the question of selection for treatment. Second, a thorough analysis is made of the criteria used for life termination. Third, a case of a newborn with a very severe MMC is presented as a 'reference case'. Conclusion: 'Unbearable and hopeless suffering' cannot be applied to newborns with MMC. They are not 'terminally ill' and do have 'prospects of a future'. In these end-of-life decisions, 'quality of life judgments' should not be applied. When such a newborn is not treated, modern palliative care always will suffice in eliminating possible discomfort. There is no reason whatsoever for active life-termination of these newborns

Women's Experiences with and Preference for Induction of Labor with Oral Misoprostol or Foley Catheter at Term

Objective We assessed experience and preferences among term women undergoing induction of labor with oral misoprostol or Foley catheter.  Study Design In 18 of the 29 participating hospitals in the PROBAAT-II trial, women were asked to complete a questionnaire within 24 hours after delivery. We adapted a validated questionnaire about expectancy and experience of labor and asked women whether they would prefer the same method again in a future pregnancy. Results The questionnaire was completed by 502 (72%) of 695 eligible women; 273 (54%) had been randomly allocated to oral misoprostol and 229 (46%) to Foley catheter. Experience of the duration of labor, pain during labor, general satisfaction with labor, and feelings of control and fear related to their expectation were comparable between both the groups. In the oral misoprostol group, 6% of the women would prefer the other method if induction is necessary in future pregnancy, versus 12% in the Foley catheter group (risk ratio: 0.70; 95% confidence interval: 0.55-0.90; p = 0.02).  Conclusion Women's experiences of labor after induction with oral misoprostol or Foley catheter are comparable. However, women in the Foley catheter group prefer more often to choose a different method for future inductions