Patient Safety in the Use of Mechanical Restraints: Regulatory Compliance among Hospitals in the City of Buenos Aires and Proposal for Its Improvement

Introduction: Mechanical or physical restraint is an exceptional therapeutic resource to immobilize a subject and thus guarantee the safety of the patient and/or third parties in the face of high-risk behaviors, but it entails multiple crossings (bioethical, philosophical, medical, psychological, legal). Framed in the so-called “safety culture” developed by the WHO, based on the Protocol for its implementation of the CABA and attentive to its frequent use in CABA by different hospital services (medical clinic, geriatrics, intensive care and medical guards) we consider it necessary its study in terms of compliance with the risks it entails and its management. Objectives: Identify regulatory compliance with the GCABA Mechanical restraint (MR) Protocol from a patient safety perspective, as well as describe the clinical and medicolegal aspects, and propose the usefulness of a tool for its management and control. Methodology: Observational, descriptive, transversal and prospective work through the analysis of Clinical Records with indication of MR using a rubric-type form. 177 cases were analyzed between September-November 2023 from three hospitals of the Government of the City of Buenos Aires, statistical parameters were applied and graphs were made. Results: Only 12.99% complied with the Protocol. In the mental health specialized hospital compliance was almost 5 times greater than in the general one, and in the emergency services compliance was 12 times greater than in Inpatient services. We found that the start or end time of MR was not recorded and only 43% described the causes/justifications for the indication (mostly in Emergency and Specialized hospitals), with the MR average time being shorter in Emergency. Conclusions: Only 1.3 out of 10 patients reliably completed the Protocol and it was mostly in the mental health specialized hospital and the emergency services. The results show non-compliance behavior in the application and management of the risk that the use of mechanical restraints entails, being causes for criminal litigation. We consider that the checklists are useful to complete the Protocol and thus provide security to patients and professionals.

Macrobioerosion and Microbioerosion in Marine Molluscan Shells from Holocene and Modern Beaches (39°-40°S, South of Buenos Aires Province, Argentina)

The marine sediments of the area of Verde Peninsula - Jabali Island （39°28＇S/62°19%V-40°28＇ S/62°11＇W） Holocene in age （3-2 ky）, and modern beaches contain a significant amount of bioeroded mollusc shells. Fifteen sites were analyzed, in which 20.11% of the mollusc shells （2168 valves） presented bioerosion traces, in 54 species （30 bivalves and 24 gastropods）. Fourteen ichnogenera were reported： Entobia, Maeandropolydora, Iramena, Caulostrepsis, Pennatichnus, Pinaceocladichnus, Trypanites, and Gastrochaenolites （Domichnia）, Gnathichnus and Radulichnus （Pascichnia）, Finichnus and Centrichnus （Fixichnia）, Oichnus （Praedicnia） （macrobioerosion）, y Semidendrina （microbioerosion）, the latter is first reported in mollusc shells in Argentina. Eleven ichnospecies were identified Finichnus peristroma, Maeandropolydora sulcans, Gnathichnus pentax, Pinaceocladichnus onubensis, Caulostrepsis taeniola, Centrichnus eccentricus, Radulichnus inopinatus, Oichnus simplex, Oichnus paraboloides, Oichnus gradatus, and Gastrochaenolites torpedo （lithic remains）. The dominant ichnogenera in the Holocene deposits are Iramena, Entobia and Oichnus. The same ichnogenera are constant with different abundance in the modern beaches, and increasing representation of Pinaceocladichnus and Pennatichnus. The dominant ichnofacies in the Holocene deposits is Trypanites, revealing a benthonic marine community composed of cheilostome bryzoans, clionaid sponges, predator gastropods, regular echinoids, polychaete annelids, bivalves, thallophytas and fungi. Generally, the area was described as a sublittoral, low-energy, stable environment with high rate of oxygenation, and sandy bottoms, with rocky bottoms at Villalonga locality.

Puerto Madero and Porto Maravilha： The Transformation Process of Port Areas into Tourist Zones

Transformations in the use of urban space in contemporary cities have common features and projects in the global era take similar themes, such as requalifications of port areas and waterfronts. The main objective of this paper is to revisit the process of urban transformation and valorization of the port areas of Buenos Aires, Argentina, and Rio de Janeiro, Brazil, completed in 1990 and 2015, respectively. It recapitulates their historical processes from decay to recovery as tourist zones, following the implementation of the ＂Strategic Plan of Antiguo Puerto Madero＂, from 1990, in Buenos Aires, and of ＂Urban Operation Porto Maravilha＂, from 2009, in Rio de Janeiro. While planning and strategies differ as they sought distinct locations in different times, they were similar in attracting massive investment from the real estate market. Therefore, consequences of the projects for the cities and the local population are a more important issue than formal results achieved.

The Raid of the ＂Plus Ultra＂. The First Aerial Crossing of the South Atlantic Ocean

When World War I ended in 1918 the aviators wanting to fly higher and further and they started a raced in which everyone wanted to be first. The Spanish pilots were initially excluded by the Moroccan War, which demanded all available air forces be used to put an end to the conflict. Motivated by the successes of The Alhucemas amphibious landing, one of best Spanish aviators, Major Ramon Franco presented to the Government in 1925 a project to undertake a flight to Argentina across the South Atlantic Ocean in a DornierJ Wal seaplane. In the memorandum, Franco said： The Spain-Argentina flight would be a worthwhile trial and verification of air navigation. It would also serve to let the entire world know of the merits of our Aviation and allow us to occupy the aeronautical place that belongs to us in aeronautics. It would also help us strengthen our ties with our brothers at the other side of the ocean. The DornierJ Walwas named ＂Plus Ultra＂ referring to the Discovery of America. The route should be Palos de la Frontera-Las Palmas de Gran Canaria-Cape Verde islands-Fernando Noronha island-Pernambuco-Rio de Janeiro-Montevideo and Buenos Aires. Franco reasoned that the best time of year to make the flight was from December to April. The raid started in the city Palos de la Frontera on 22 January 1926 and ended in Buenos Aires on February 9, after flying 10,825 kilometers in 59 hours and 48 minutes.