Background: Patients in critical care setting often encounter severe delirium and agitation putting them at risk of harm. So it has become a common trend to restraint patient physically in intensive care units. However, physical restraint has several adverse physical, psychological and ethical consequences. Awareness regarding significant risk associated with physical restraint, continuing education and skills stabilize the patient's safety and potential complication regarding ethical and legal issues to physical restraint in critical care settings. This study aims to address if any alternatives have been tested regarding physical restraint to improve the patient care for critical care. Methodology: A search conducted using the PubMed, Medline and Google Scholar including physical restraint use in critical care setting from 1994 to 2017. Studies published in English were included whereas articles published in psychiatric care, children and outside the hospital were excluded. The keywords used were critical care, critically ill, ICU patient safety and physical restraint. The Boolean phrases were used to clarify the quality of search results: ''physical restraint & critical care,'' ''physical restraint & critically ill'' ''physical restraint & ICU,'' physical restraint & patient safety.'' Additionally, reference lists of selected papers were then evaluated further. Results: Enhanced knowledge, focused education and continuing training to improve skills in using restraint alternatives, awareness of the risk, early identification, conduct proper institutional policies and guidelines, and proactive intervention is the significant measures in alleviating physical restraint use in critical care settings. Conclusion: A restraint-free environment not only promotes patient safety but also ensure greater caregivers' job satisfaction reducing ethical issues.
According to characteristics of high flow, high inertia load, variable stiffness of test platform in marine component mechanical properties, considering the president research status of hydraulic servo system, this paper establish the mathematical model of hydraulic servo system of test platform and give a analysis to load performance of test platform, and come up with a method that using flow servo valve and proportional relief valve combination control to realize loading force controlled by close loop. This method can realize loading force under controlling and improve the precision of control system.
Os biocombustíveis vêm sendo explorados na tentativa de reduzir as emissões de gases do efeito estufa e o consumo de combustíveis fósseis. Por esses mesmos propósitos, as recentes diretrizes legais sobre o controle de emissões demandam maiores eficiências para motores de ignição por centelha (SI) operando em carga parcial. Nesse contexto, este estudo investigou a utilização de estratégias não convencionais de tempos de válvula em um motor de testes monocilíndrico de 0,35 L e quatro válvulas operando com etanol anidro. Esse era equipado com um sistema de atuação de válvulas independente que permitia variabilidade total de momentos de abertura e fechamento de válvulas. Os processos negative valve overlap (NVO) e exhaust rebreathing (ER) foram avaliados como estratégias de aprisionamento de gases residuais. O fechamento precoce das válvulas de admissão (early intake valve closure, EIVC) foi empregado como método de controle de carga. A combustão SI convencional, com controle de carga através de restrição por borboleta na admissão (throtle spark ignition, tSI), foi testada para fins de comparação. Várias cargas parciais foram avaliadas em rotação fixa de 1500 rpm. O aumento de eficiência indicada pôde ser alcançado ao aplicar as estratégias de NVO e ER.
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