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Sample records for child restraint system

  1. Child restraint system for children in cars - CREST results

    NARCIS (Netherlands)

    Schrooten, M.; Cassan, F.; Trosseille, X.

    2001-01-01

    Child restraint systems (CRS) for cars are intended to protect children in the case of a car accident. Unfortunately their effectiveness is still too low: in the range 30-50% when it would be expected to be much higher. The low effectiveness of child restraint systems can partly be explained for the

  2. Child restraint system for children in cars - CREST results

    NARCIS (Netherlands)

    Schrooten, M.; Cassan, F.; Trosseille, X.

    2001-01-01

    Child restraint systems (CRS) for cars are intended to protect children in the case of a car accident. Unfortunately their effectiveness is still too low: in the range 30-50% when it would be expected to be much higher. The low effectiveness of child restraint systems can partly be explained for the

  3. 76 FR 10637 - Consumer Information; Program for Child Restraint Systems

    Science.gov (United States)

    2011-02-25

    ... Program (CREP) B. Consumers Union C. EuroNCAP D. Japan NCAP (JNCAP) E. New Program for the Assessment of... restraint's Manufacturer's Suggested Retail Price. To ensure recommended CRS satisfy the proposed fit... centers, recreation centers, and restaurants in five fast food chains, it determined that 99 percent of...

  4. Has Child Restraint System Use Increased among Parents of Children in Shantou, China?

    Directory of Open Access Journals (Sweden)

    Huiqian Lei

    2016-09-01

    Full Text Available Objective: to examine parents’ use of child restraint systems (CRS, and determine if parents’ knowledge of, attitude toward, and use behavior of child restraint systems have improved following enactment of child restraint use laws in other cities. Design: Observations and a cross-sectional survey of drivers transporting children 17 years and under were conducted at the gate of the schools and parking lots of hospitals in Shantou. Observers recorded the seating location of child passengers, the type of restraint, and appropriate use of CRS and safety belts based on the observation. Knowledge of and attitudes towards use of CRS were reported by the driver following observation. Results: Approximately 6.6% of passengers aged 0–12 were in CRS; rate of forward-facing CRS in children aged 3–5 (9.9% was higher than rear-facing CRS for children aged 0–2 (1.1% and booster seat use among children aged 6–12 (0.1%. Children younger than four years old (OR = 3.395, 95% CI = 2.125–5.424, drivers having a college or higher lever education (OR = 2.908, 95% CI = 1.878–4.500 and drivers wearing seatbelt (OR = 3.194, 95% CI = 1.605–6.356 had greater odds of CRS use. Over half (56.6% of parents might or would use CRS if they could rent CRSs with fees. Conclusions: The rate of CRS is still low in Shantou. Comprehensive public education programs supported by legislation might be an effective way to improve child passenger safety. Renting CRSs to parents could be a new approach to encourage use.

  5. TRANSPORTING CHILDREN IN CARS AND THE USE OF CHILD SAFETY RESTRAINT SYSTEMS

    Science.gov (United States)

    GARCÊS, ALLAN QUADROS; COIMBRA, IGOR BONIFACIO ANDRADE; SILVA, DIEGO SALVADOR MUNIZ DA

    2016-01-01

    ABSTRACT Objective: To evaluate the transport of children in automobiles and the use of child restraints systems (CRS). Methods: This is a transversal descriptive study which included 200 vehicle drivers who carried 0-10 year old children in the city of São Luis, MA, Brazil. The drivers' passengers' and children's features were properly identified. The children's transportation using CRS were analyzed according to the Resolution 277/8 of the Brazilian National Traffic Department. Results: The transportation of children was classified as inappropriate in 70.5% of the vehicles analyzed. The most common way for children transportation was free on the back seats (47%) or on the lap of passengers/drivers (17%). The main reasons to justify the improper transportation were either not understanding the importance of CRS use (64.5%) or not having financial resources to buy the devices. The child safety seat was the most used CRS (50.8 %) among vehicles with proper child transportation system. Conclusion: The transportation of children was inappropriate in most of the vehicles analyzed, reflecting the need for creating awareness among automobile drivers, including education, supervision and improvement of policies for health improvement and prevention of accidents involving children transportation. Level of Evidence III, Cross Sectional Study. PMID:28149196

  6. Evaluation of ISO CRS Envelopes Relative to U.S. Vehicles and Child Restraint Systems.

    Science.gov (United States)

    Hu, Jingwen; Manary, Miriam A; Klinich, Kathleen D; Reed, Matthew P

    2015-01-01

    The objectives of this study are to use computer simulation to evaluate the International Organization for Standardization (ISO) 13216-3:2006(E) child restraint system (CRS) envelopes relative to rear seat compartments from vehicles and CRSs in the U.S. market, investigate the potential compatibility issues of U.S. vehicles and CRSs, and demonstrate whether necessary modifications can be made to introduce such a system into compatibility evaluations between U.S. vehicles and CRSs. Three-dimensional geometry models for 26 vehicles and 16 convertible CRS designs developed previously were used. Geometry models of 3 forward-facing and 3 rear-facing CRS envelopes provided by the ISO were built in the current study. The virtual fit process closely followed the physical procedures described in the ISO standards. The results showed that the current ISO rear-facing envelopes can provide reasonable classifications for CRSs and vehicles, but the forward-facing envelopes do not represent products currently in the U.S. market. In particular, all of the selected vehicles could accommodate the largest forward-facing CRS envelope at the second-row seat location behind the driver seat. In contrast, half of the selected CRSs could not fit within any of the forward-facing ISO CRS envelopes, mainly due to protrusion at the rear-top corner of the envelope. The results also indicate that the rear seat compartment in U.S. vehicles often cannot accommodate a large portion of convertible CRSs in the rear-facing position. The increased demand for vehicle fuel economy and the recommendation to keep children rear-facing longer may lead to smaller cars and larger CRSs, which may increase the potential for fit problems. The virtual classifications indicated that contact between the forward-facing CRSs and the head restraints in the rear seats as well as that between the rear-facing CRSs and the back of the front seats is a main concern regarding the compatibility between the vehicles and the

  7. Seat belt restraint system

    Science.gov (United States)

    Garavaglia, A.; Matsuhiro, D.

    1972-01-01

    Shoulder-harness and lap-belt restraint system was designed to be worn by individuals of widely different sizes and to permit normal body motion except under sudden deceleration. System is divided into two basic assemblies, lap belt and torso or shoulder harness. Inertia-activated reels immediately lock when seat experiences sudden deceleration.

  8. Roadside observation of child passenger restraint use

    Directory of Open Access Journals (Sweden)

    Beth Bruce

    2015-10-01

    Full Text Available Background: Despite legislation and research evidence supporting the use of childhood vehicle restraints, motor vehicle crashes remain the leading cause of injury, death and disability among Canadian children. Methods: Working in collaboration with trained car seat specialists and police officers, roadside checks were conducted to observe correct use of child restraints. Results: Of the 1323 child vehicle restraints inspected, 99.6% of the children were restrained, 91% were in the correct seat, and 48% of restraints were correctly installed. The seat/restraint types most used incorrectly used were booster seats (31% and seat belts (53%. The majority of incorrectly installed or fitted seats (55% were forward facing. Common errors in installation and fit included the seat not being secured tightly enough to the vehicle, incorrect tether strap use, the harness not being tight enough, and/or the chest clip being in the wrong place. Conclusions: The greatest proportion of incorrect seat use was among those children who transitioned to a seat belt too soon. The greatest proportion of installation and fit errors were among forward facing seats. Researchers recommend: 1 targeting parents with older children (ages 3 and above regarding transitioning too soon from forward facing seats to booster seats, and from booster seats to seat belts; 2 targeting parents with younger children regarding correct installation of rear facing and forward facing seats; 3 collaborating with police officers to review the most common errors and encourage observation at roadside checks; and 4 creating community awareness by way of roadside checks.

  9. 32 CFR 636.34 - Restraint systems.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 4 2010-07-01 2010-07-01 true Restraint systems. 636.34 Section 636.34 National... Restraint systems. (a) Restraint systems (seat belts) will be worn by all operators and passengers of U.S. Government vehicles on or off the installations. (b) Restraint systems will be worn by all civilian personnel...

  10. 49 CFR 571.213 - Standard No. 213; Child restraint systems.

    Science.gov (United States)

    2010-10-01

    ... maximum calculated head injury criterion (HIC36) shall not exceed 1,000, determined using the resultant... designed to be used rearward-facing for infants and forward-facing for older children, the statement: Use... seating platform that does not extend up to provide a cushion for the child's back or head and has a...

  11. Free child passenger restraints for patients in an urban pediatric medical home: effects on caregiver behavior.

    Science.gov (United States)

    Brixey, Suzanne; Guse, Clare E; Ngui, Emmanuel

    2009-10-01

    Motor vehicle crashes are a leading cause of death in children despite the availability of effective child passenger restraints that reduce morbidity and mortality. Inappropriate restraint is more common in minority and low-income populations. Removing barriers by distributing child passenger restraint systems (CPRS) and providing education has been 1 approach to improve child safety. The objective of this study was to evaluate the efficacy of providing no-cost CPRS in combination with targeted education to improve restraint use for low-income, minority, and urban children in a medical home. This prospective, non-randomized, community-based cohort study used a certified car seat technician to provide CPRS and training to the caregivers of 101 children when those caregivers reported not owning the appropriate type of restraint system during the index clinic visit. In the first 3 months of follow-up, caregivers were 2.4 times more likely to report appropriate use of CPRS: relative risk 2.4 (95% confidence interval [CI] 1.7 to 3.5). Reported improvement declined slightly between months 4 and 9. Appropriate restraint significantly improved, yet rates remained suboptimal. Multifactoral approaches are needed to understand why the set of patients studied and other at-risk populations may not use child restraints properly even when given access and information.

  12. Designing and evaluating a persuasive child restraint television commercial.

    Science.gov (United States)

    Lewis, Ioni; Ho, Bonnie; Lennon, Alexia

    2016-01-01

    Relatively high rates of child restraint inappropriate use and misuse and faults in the installation of restraints have suggested a crucial need for public education messages to raise parental awareness of the need to use restraints correctly. This project involved the devising and pilot testing of message concepts, filming of a television advertisement (the TVC), and the evaluation of the TVC. This article focuses specifically upon the evaluation of the TVC. The development and evaluation of the TVC were guided by an extended theory of planned behavior that included the standard constructs of attitudes, subjective norms, and perceived behavioral control as well as the additional constructs of group norms and descriptive norms. The study also explored the extent to which parents with low and high intentions to self-check restraints differed on salient beliefs regarding the behavior. An online survey of parents (N = 384) was conducted where parents were randomly assigned to either the intervention group (n = 161), and therefore viewed the advertisement within the survey, or the control group (n = 223), and therefore did not view the advertisement. Following a one-off exposure to the TVC, the results indicated that, although not a significant difference, parents in the intervention group reported stronger intentions (M = 4.43, SD = 0.74) to self-check restraints than parents in the control group (M = 4.18, SD = 0.86). In addition, parents in the intervention group (M = 4.59, SD = 0.47) reported significantly higher levels of perceived behavioral control than parents in the control group (M = 4.40, SD = 0.73). The regression results revealed that, for parents in the intervention group, attitudes and group norms were significant predictors of parental intentions to self-check their child restraint. Finally, the exploratory analyses of parental beliefs suggested that those parents with low intentions to self-check child restraints were significantly more likely than

  13. A study of the effects of current and proposed restraint concepts on the child occupants of vehicles

    OpenAIRE

    2000-01-01

    This research evaluates the performance of automotive child restraint systems (CRS) that conform to international proposals for a universal restraint concept to be adopted by both restraint and vehicle manufacturers. The concept is known as Isofix (International Standards Organisation FIXing), and is intended to ensure optimum compatibility and coupling between vehicle and CRS. In order to quantify the benefits of the proposed Isofix concept it has been necessary to establish the performan...

  14. Development of a validated aircraft child restraint model

    NARCIS (Netherlands)

    Pipino, M.; Mugnai, A.; DeWeese, R.L.

    1999-01-01

    Studies conducted at the FAA Civil Aeromedical Institute have shown that when used in aircraft, automotive Child Restraint Devices (CRDs) do not always provide the level of safety desired. Various factors that contribute to poor performance, such as seat belt anchor location, cushion stiffness, and

  15. Geometry of rear seats and child restraints compared to child anthropometry.

    Science.gov (United States)

    Bilston, Lynne E; Sagar, Nipun

    2007-10-01

    The objective of this study was to evaluate the geometry of a wide range of restraints (child restraints, booster seats and rear seats) used by children, and how these match their anthropometry, and to determine limitations to restraint size for the population of children using them. The study is motivated by the widespread premature graduation from one restraint type to another, which parents often attribute to children outgrowing their previous restraint. Currently, recommended transitions are based on a small sample of vehicles and children. Outboard rear seat and seat belt geometry (anchorage locations, sash belt angles) from 50 current model vehicles were measured using a custom-developed measuring jig. For 17 child restraints, a 3-dimensional measuring arm was used to measure the geometry of the restraint including interior size and strap slot locations (where relevant). These measurements were compared to anthropometric measurements, to determine the suitability of a given restraint for children of particular ages. The results for the rear seat geometry indicate that all seat cushions were too deep for a child whose upper leg length is at the 50th percentile until approximately 11.5 years, and half of vehicle seat cushions were too deep for a 15 year old child whose upper leg length is at the 50th percentile. Sash belt geometry was more variable, with approximately a third of vehicles accommodating 6-8 year olds who approximate the shoulder geometry measurements at the 50th percentile. Dedicated child restraints accommodated most children within recommended age groups, with two exceptions. Several high back booster seats were not tall enough for a child whose seated height is at the 50th percentile for 8 year olds (who is still too short for an adult belt according to current guidelines and the results from the rear seat geometry study), and a small number of forward facing restraints and high back boosters were too narrow for children at the upper end of

  16. Protecting children: a survey of caregivers’ knowledge of Georgia’s child restraint laws

    Directory of Open Access Journals (Sweden)

    Sheryl Strasser

    2010-11-01

    Full Text Available Sheryl Strasser1, Laurie Whorton2, Amanda J Walpole3, Sarah Beddington11Institute of Public Health, Partnership for Urban Health Research, Georgia State University, Atlanta, GA, USA; 2WellStar Corporate and Community Health, Marietta, GA, USA; 3Cobb and Douglas Public Health, Marietta, GA, USAIntroduction: The leading cause of injury and death among children in the United States is motor vehicle crashes. Even though restraint laws are in place and public awareness campaigns and educational interventions have increased, many children are still improperly restrained or not restrained at all. When correctly used, child restraints significantly reduce risk of injury or death.Methods: The purpose of the study was to elicit caregiver baseline knowledge of car seat installation and regulation before receiving car seat education from certified technicians at Inspection Station events. Inspection Station is a program whereby staff assists parents in correctly positioning car seats in participants’ vehicles. Over an 8-week period, Safe Kids Cobb County Car Seat Technicians distributed a 16-item survey, with 10 knowledge-based questions and six demographic questions to Inspection Station participants. Descriptive statistics and t-tests were conducted to assess relationships between participant age, ethnicity, and gender with overall knowledge scores. Regression analysis was run to determine the association between participant education level and total child restraint knowledge.Results: One hundred sixty-nine surveys were completed. Participant knowledge of vehicular child restraint ranged from 0% to 90% on all items. Only 29.6% of caregivers understood the proper tightness of the harness system. Less than half of the caregivers (43.8% were aware of the Georgia law requiring children aged 6 years and younger to be in some type of child restraint. Only 43.2% of caregivers surveyed knew that children need to ride in a rear-facing child restraint until 1

  17. CHILD CASUALTIES BEFORE AND AFTER ENACTMENT OF CHILD RESTRAINT SEATS (CRS LEGISLATION IN JAPAN

    Directory of Open Access Journals (Sweden)

    N. IWASE

    2003-01-01

    Full Text Available Road Traffic Law Article 17-3-4 of April 2000 specifies the compulsory requirement for child safety seats in Japan. The objectives of this preliminary evaluation were to measure the effectiveness, benefits and usage of safety seats for child passengers aged 0–5 years by analyzing the child casualty data for the period of 1991–2002. Two statistical methods were used to quantify time trends (interrupted time series analysis, population based casualty rates estimations of changes in child casualty incidence after implementation of compulsory child restraint seats law. Despite overall increases in the use of child restraint seats (as observed by different national surveys, casualties (fatalities and injuries among restrained children have increased. Given that exposure to crash environments is increasing, traffic safety advocates need to be aware of the importance of child restraints as a means of reducing the likelihood of injury. It is necessary to implement an extensive community-based child safety seat campaign to disseminate the information on appropriate restraint use. Further prevention of motor vehicle occupant injuries to children will require the combined approaches of education, incentives for safe human behavior, legislation/enforcement, and environmental changes.

  18. Frontal Sled Tests Comparing Rear and Forward Facing Child Restraints with 1–3 Year Old Dummies

    Science.gov (United States)

    Sherwood, C. P.; Crandall, J. R.

    2007-01-01

    Although most countries recommend transitioning children from rear facing (RF) to forward facing (FF) child restraints at one year of age, Swedish data suggests that RF restraints are more effective. The objective of this study was to compare RF and FF orientations in frontal sled tests. Four dummies (CRABI 12mo, Q1.5, Hybrid III 3yr, and Q3) were used to represent children from 1 to 3 years of age. Restraint systems tested included both 1) LATCH and 2) rigid ISOFIX with support leg designs. Rear facing restraints with support legs provided the best results for all injury measures, while RF restraints in general provided the lowest chest displacements and neck loads. PMID:18184491

  19. Frontal sled tests comparing rear and forward facing child restraints with 1-3 year old dummies.

    Science.gov (United States)

    Sherwood, C P; Crandall, J R

    2007-01-01

    Although most countries recommend transitioning children from rear facing (RF) to forward facing (FF) child restraints at one year of age, Swedish data suggests that RF restraints are more effective. The objective of this study was to compare RF and FF orientations in frontal sled tests. Four dummies (CRABI 12 mo, Q1.5, Hybrid III 3 yr, and Q3) were used to represent children from 1 to 3 years of age. Restraint systems tested included both 1) LATCH and 2) rigid ISOFIX with support leg designs. Rear facing restraints with support legs provided the best results for all injury measures, while RF restraints in general provided the lowest chest displacements and neck loads.

  20. Association between weight and risk of crash-related injuries for children in child restraints.

    Science.gov (United States)

    Zonfrillo, Mark R; Elliott, Michael R; Flannagan, Carol A; Durbin, Dennis R

    2011-12-01

    To determine the association between weight and the risk of injury in motor vehicle crashes (MVCs) for children 1 through 8 years of age who were using child restraints. This was a cross-sectional study of children 1 to 8 years of age in MVCs, in which cases from the National Automotive Sampling System Crashworthiness Data System were used. Abbreviated Injury Scale scores of ≥2 indicated clinically significant injuries. The National Automotive Sampling System Crashworthiness Data System study sample included 650 children 1 to 5 years of age in forward-facing child restraints who weighed 20 to 65 lb and 344 children 3 to 8 years of age in belt-positioning booster seats who weighed 30 to 100 lb. With adjustment for seating position, type of vehicle, direction of impact, crash severity, and vehicle model year, there was no association between absolute weight and clinically significant injuries in either age group (odds ratio: 1.17 [95% confidence interval: 0.96-1.42] for children 1-5 years of age in forward-facing child restraints and 1.22 [95% confidence interval: 0.96-1.55] for children 3-8 years of age in belt-positioning booster seats). The risk of clinically significant injuries was not associated with weight across a broad weight range in this sample of children in MVCs who were using child restraint systems. Parents should continue to restrain their children according to current recommendations from the American Academy of Pediatrics and the National Highway Traffic Safety Administration.

  1. Disparities in age-appropriate child passenger restraint use among children aged 1 to 12 years.

    Science.gov (United States)

    Macy, Michelle L; Cunningham, Rebecca M; Resnicow, Ken; Freed, Gary L

    2014-02-01

    Observed racial disparities in child safety seat use have not accounted for socioeconomic factors. We hypothesized that racial differences in age-appropriate restraint use would be modified by socioeconomic status and child passenger safety information sources. A 2-site, cross-sectional tablet-based survey of parents seeking emergency care for their 1- to 12-year-old child was conducted between October 2011 and May 2012. Parents provided self-report of child passenger safety practices, demographic characteristics, and information sources. Direct observation of restraint use was conducted in a subset of children at emergency department discharge. Age-appropriate restraint use was defined by Michigan law. Of the 744 eligible parents, 669 agreed to participate and 601 provided complete responses to key variables. White parents reported higher use of car seats for 1- to 3-year-olds and booster seats for 4- to 7-year-olds compared with nonwhite parents. Regardless of race, children who were ≤4 feet, 9 inches tall used a booster seat. White parents had higher adjusted odds (3.86, 95% confidence interval 2.27-6.57) of reporting age-appropriate restraint use compared with nonwhite parents, controlling for education, income, information sources, and site. There was substantial agreement (82.6%, κ = 0.74) between parent report of their child's usual restraint and the observed restraint at emergency department discharge. Efforts should be directed at eliminating racial disparities in age-appropriate child passenger restraint use for children children.

  2. Community paediatricians' counseling patterns and knowledge of recommendations relating to child restraint use in motor vehicles.

    Science.gov (United States)

    Rothenstein, J; Howard, A; Parkin, P; Khambalia, A; Macarthur, C

    2004-04-01

    Road traffic injury is the leading cause of death among Canadian children and youth. Transport Canada recommends four types of child restraint depending on the size of the child, and recent studies have demonstrated the effectiveness of recommended restraint use. To determine community paediatricians' knowledge of Transport Canada recommendations for child restraint use in vehicles, and to examine paediatricians' counseling patterns in relation to child passenger safety. A mailed questionnaire survey of all community paediatricians affiliated with the Hospital for Sick Children, Toronto was conducted. A 16 item questionnaire gathered information on knowledge of Transport Canada recommendations for child restraint use, general counseling patterns in relation to child passenger safety, and demographic information. In total, 60 community paediatricians in active practice were identified. Of these, 48 (80%) responded to the mailed questionnaire. Almost all paediatricians (92%) correctly identified the recommended weight for transition to a forward-facing car seat, whereas fewer paediatricians (63%) correctly identified the recommended weight for transition to a booster seat from a forward-facing car seat, and only one third of paediatricians correctly identified the recommended weight for transition from a booster seat to a seat belt. Community paediatricians' knowledge of Transport Canada recommendations for child restraint use in vehicles is incomplete. There is a need for such recommendations to be better disseminated to paediatricians and parents so that information on child restraint use is delivered in a clear and consistent manner.

  3. 基于不同年龄的自适应儿童乘员约束系统参数优化研究%Research on the Optimization of Intelligent Child Restraint Systems Based on Children of Different Ages

    Institute of Scientific and Technical Information of China (English)

    白中浩; 陈亚枫; 程胜华; 王玉龙

    2015-01-01

    针对单一碰撞工况匹配的儿童乘员约束系统不能保证在其他碰撞工况下儿童乘员的保护,而且极易造成更大的伤害。基于内置式自适应儿童约束系统的参数可调的特征,选取坐垫高度、坐垫长度、安全带限力值为优化变量,以儿童综合伤害评价值I及颈部损伤临界值Nkm为优化目标,采用多项式回归近似模型和非支配遗传优化算法(Non-dominated sorting genetic algorithm II, NSGA-Ⅱ)相结合的方法,分别对3、6、10岁儿童假人在法规GB 27887规定的正面碰撞和追尾碰撞工况下进行多目标优化计算。优化结果表明,在优化设计点,3个年龄段的儿童假人在两种碰撞工况下都能获得较好的保护。基于文中3个年龄段假人的优化设计点,拟合出优化变量与儿童身高和体重的相关关系模型,从而对不同身高和体重的儿童乘员都能达到很好的保护效果。%Child restraint systems designed to match child occupant only under one collision condition can’t provide effective protection for children under other collision condition. An adaptive child restraint system, which characteristic parameters are adjustable, is used to analyze the optimum parameters of restraint system for child occupants at different ages. The seat height, the cushion length and the force limiter value of the seat belt are chosen as optimization variables, and children’s comprehensive damage evaluation I and neck injury thresholdNkm are chosen as optimization objectives. The methods of approximate model of polynomial regression and non-dominated sorting genetic algorithm II are combined to conduct, multi-objective optimization for 3, 6, 10 years old child dummy respectively in both the front impact and rear impact according to GB 27887. The results show that the optimized parameters of restraint system can provide a better protection for children of the three age group in the two collision conditions

  4. Seatbelt and child-restraint use in Kazakhstan: attitudes and behaviours of medical university students.

    Science.gov (United States)

    Nugmanova, Zhamilya S; Ussatayeva, Gainel; McNutt, Louise-Anne

    2015-04-01

    Traffic fatalities in Kazakhstan increased from 15 to more than 30 per 100 000 between 2001 and 2006. Mortality remains high compared with developed nations. Safety-restraint laws have been enacted, but little data exist regarding usage of seatbelts, particularly among children and passengers. This cross-sectional study surveyed medical university students about attitudes and behaviours regarding seatbelt and child safety-restraint usage. Seatbelts are widely used in the front seat (81%) but not in the back seat (79% 'never' or 'rarely' use a seatbelt in the back seat). Fewer than half reported 'always' or 'almost always' providing restraint for children under 7 years and 24% reported children secure the seatbelts themselves. Safety in the back seat merits attention. Adults generally do not buckle in the back seat despite a law requiring seatbelt use. Promotion of child safety restraints should be prioritised in prevention education for physicians and the community.

  5. Poor compliance with child safety restraint use while travelling.

    LENUS (Irish Health Repository)

    Fallon, R

    2011-02-01

    Road traffic accidents are a leading cause of death of children. It is the law that all children should be appropriately secured when traveling in vehicles. The aim of this study was to evaluate parental conformity with these regulations and to test if advice given at a Paediatric outpatient clinic could improve compliance. Two groups were assigned, an intervention group (parents given an information leaflet and a clear explanation about appropriate restraints for their children) and a non-intervention group (received no information). They were contacted again after 2 months and asked regarding compliance. A total of 394 children from 186 families were initially given the questionnaire. Nearly one third of children (29.2%) were not using any restraint while travelling rising to 35.3% on follow up. This study concluded that once off parental education made negligible difference to an already inconsistent and haphazard approach to compliance with safety regulations.

  6. Learning from Tragedy: A Survey of Child and Adolescent Restraint Fatalities

    Science.gov (United States)

    Nunno, Michael A.; Holden, Martha J.; Tollar, Amanda

    2006-01-01

    Objective: This descriptive study examines 45 child and adolescent fatalities related to restraints in residential (institutional) placements in the United States from 1993 to 2003. Method: The study team used common Internet search engines as its primary case discovery strategy to determine the frequency and the nature of the fatalities, as well…

  7. Behavioral Skills Training to Improve Installation and Use of Child Passenger Safety Restraints

    Science.gov (United States)

    Himle, Michael B.; Wright, Kalon A.

    2014-01-01

    The risk for serious injury and death to children during motor vehicle accidents can be greatly reduced through the correct use of child passenger safety restraints (CPSRs). Unfortunately, most CPSRs are installed or used incorrectly. This study examined the effectiveness of behavioral skills training (BST) to teach 10 participants to install…

  8. ISOFIX型儿童座椅正面碰撞台车试验的有限元仿真%FE Simulation of Frontal Crash Sled Test with ISOFIX Child Restraint System

    Institute of Scientific and Technical Information of China (English)

    胡佳; 水野幸治

    2011-01-01

    A finite element (FE) model for ISOFIX child restraint system (CRS) is developed and by using the FE model for Hybrid Ⅲ 3-year-old child dummy, a FE model for the frontal crash sled test with ISOFIX CRS is set up. Based on the model a simulation is performed and the results of sled test and its simulation are compared in terms of kinematic behavior, head, chest and pelvis accelerations, and injury values of the dummy. Then the effectiveness of a top-tether force limiter is evaluated with FE model. It is found that the results of FE simulation agree well with that of sled test, and the injury values of the dummy are all below injury indicators. With a top-tether force limiter applied, the head forward displacement, though increases, is still far below its indicator value,while all other injury values reduce to different extents.%建立了ISOFIX型儿童座椅的有限元模型,并应用HybridⅢ3岁儿童假人有限元模型,建立了ISOFIX型儿童座椅正面碰撞台车试验的有限元模型,进行了仿真,对比分析了台车试验与有限元仿真的假人动态举动,头部、胸部和髋部的合成加速度波形及假人伤害值.接着用有限元模型对儿童座椅上拉带限力效果进行了评价.结果表明,有限元模型仿真结果与试验结果基本吻合,假人伤害值均在法规指标值以内.上拉带限力虽使头部最大前向移动量有所增加,但仍远小于指标值,且其他伤害值都有不同程度的降低.

  9. Safety restraint systems in heavy truck rollover scenarios

    NARCIS (Netherlands)

    Slaats, P.M.A.; Coo, P.J.A. de

    2003-01-01

    Safety restraint systems have been widely applied in the passenger car industry. The heavy truck industry has followed along, integrating the seat belts in the seat system. The effectiveness of seat belts, in particular in rollover scenarios, was studied for a number of heavy truck rollover scenario

  10. 77 FR 11625 - Child Restraint Systems

    Science.gov (United States)

    2012-02-27

    ... of the dummy's chin with the upper sternal bib region covering the upper portion of a metal ``spine... rule, achieves a balance. It will accommodate the majority of CRS manufacturers.\\21\\ It is possible...

  11. 中国两城市使用儿童安全座椅影响因素分析%Analysis on influencing factors for child restraint system use in Shanghai and Shenzhen, China

    Institute of Scientific and Technical Information of China (English)

    邓晓; 金叶; 彭绩; 夏庆华; 马剑平; 王临虹; 段蕾蕾

    2016-01-01

    目的 分析家长使用儿童安全座椅的影响因素,为制定适宜干预措施及促进使用儿童安全座椅提供依据和建议.方法 采用自填式问卷调查法,对上海和深圳市分层整群随机抽样的7 528户家庭拥有≥1辆私家轿车的0~6岁儿童家长进行儿童安全座椅使用情况及影响因素调查;采用小组焦点访谈法,随机抽取完成问卷调查的家长访谈使用或不使用儿童安全座椅的原因等.结果 39.23%(2 820/7 189)的调查对象家庭拥有儿童安全座椅,儿童乘私家车出行时总是使用儿童安全座椅的比例为17.14%(1 232/7 189).儿童年龄小、父母教育水平高、家庭经济条件好、家长对儿童乘车安全认知好是使用儿童安全座椅的保护性因素.儿童乘车出行的频率、距离和驾驶员安全带佩戴行为显著影响儿童安全座椅的使用.家长不购买儿童安全座椅的主要原因包括占用车内空间(53.33%,2 329/4 367)、乘车机会少(48.55%,2 120/4 367)、安装麻烦(42.25%,1 845/4367)、价格过高(38.58%,1 685/4 367)、质量不可靠(31.03%,l 355/4 367);不使用的主要原因包括儿童不想坐(67.36%,293/435)、出行距离近(53.79%,234/435)、安装使用不方便(53.10%,231/435)、车内没有空间(32.41%,141/435)及认为没有必要(25.75%,112/435).结论 家长在使用儿童安全座椅保护儿童乘车安全方面存在认知盲区和误区,并亟需对儿童安全座椅正确选购和使用的技术指导和服务,建议采取综合性干预措施,包括加强宣传教育、推进立法与执法、加强市场监管、建立儿童安全座椅相关服务站点、探索租赁市场等.%Objective To understand the factors related with child restraint system (CRS) use,and provide evidence for the development of appropriate intervention measures to promote the use of CRS for the protection of child passengers' safety.Methods Self-administrated questionnaire survey was

  12. Biomechanics of seat belt restraint system.

    Science.gov (United States)

    Sances, Anthony; Kumaresan, Srirangam; Herbst, Brian; Meyer, Steve; Hock, Davis

    2004-01-01

    Seat belt system restrains and protects occupants in motor vehicle crashes and any slack in seat belt system induces additional loading on occupant. Signs of belt loading are more obvious in high-speed frontal collisions with heavy occupants. However subtle changes may occur at low speeds or with low forces from occupants during rollovers. In certain cases, the seat belt webbing is twisted and loaded by the occupant. The loading of webbing induces an observable fold/crimp on the seat belt. The purpose of the study is to biomechanically evaluate the force required to produce such marks using an anthropometric physical test dummy. Two tests were conducted to determine the amount of force required to put an observable fold/crimp in a shoulder belt. A head form designed by Voight Hodgson was used to represent the neck which interacted with the belt. The force was applied with a pneumatic pull ram (central hydraulic 89182 N) and the force was measured with a 44,000 N transducer load cell (DSM-10K). Results indicate that the force of over 1,000 N produced a fold or crimp in the belt.

  13. Effect of restraint stress on nociceptive responses in rats: role of the histaminergic system.

    Science.gov (United States)

    Ibironke, G F; Mordi, N E

    2011-12-20

    Stress induced analgesia (SIA) is well known, but the reverse phenomenon, hyperalgesia is poorly documented. This study investigated the role of the histaminergic system in restraint stress hyperalgesia in rats, using thermal stimulation method (hot plate and tail flick tests). Paw licking and tail withdrawal latencies were taken before and after restraint for about one hour. Significant decreases (p<0.05) were obtained in these latencies after the restraint in both tests. Administration of H1 and H2 receptor blockers, chlorpheniramine and cimetidine respectively 30 mins before the restraint still resulted in significant reductions (p<0.05) in these latencies, connoting the persistence of hyperalgesia, showing that histamine H1 and H2 receptors did not participate in the mechanism of restraint stress hyperalgesia. We therefore suggest a histaminergic independent mechanism for restraint stress induced hyperalgesia.

  14. Seat belts, airbags and child protection devices. [previously: Seat belts and child restraint seats.

    NARCIS (Netherlands)

    2010-01-01

    In the Netherlands, the use of seat belts results in a yearly reduction of hundreds of fatalities. Seat belts reduce the risk of fatal injury by 37 to 48%, depending on the position in the car. At 50%, the effect of child protection devices is even slightly higher. When last measured (in 2010), 97%

  15. Casting technique and restraint choice influence child safety during transport of body casted children subjected to a simulated frontal MVA.

    Science.gov (United States)

    Zielinski, Julie; Oliver, Glen; Sybesma, Justin; Walter, Norman; Atkinson, Patrick

    2009-06-01

    Hip spica casts (or body casts) are commonly applied to young pediatric trauma and hip dysplasia patients. The greatest hip stability in the cast is achieved via fixed hip flexion or abduction and fixed knee flexion. Unfortunately, this fixed position causes difficulties in restraining children for transport because the child cannot typically accommodate their body to the child car seat geometry. The objectives of the current study were to identify a range of reasonable seating options for casted children. These positions were then studied in frontal crash tests to identify the relative injury exposure for the different positions. A revised casting technique was also investigated in an effort to address head-to-cast contact identified during the course of the study. The current study assessed the ability for different child seats and the vehicle seat belts to accommodate casted 1-year-old and 3-year-old crash test dummies. The restrained dummies were then subjected to frontal 30-mph crash tests with uncasted dummies serving as a control. In general, traditional child seats were able to accommodate both children; however, the child's body shifted anteriorly in the cast when the belts were tightened. This shift produced concerns for pulmonary function and the potential for elevated pressure on the superior mesenteric artery. This anterior shift of the chest was reduced when the dummies were restrained by a special hip spica child seat or solely by the vehicle seat belts. When considering all restraint types, the addition of the cast increased the majority of the injury metric magnitudes. For the 3-year-old dummy these increases were determined to be related to the casting technique; an alternative technique significantly reduced the injury metrics. This study demonstrates that there are anticipated variable effects on basic physiologic function for body-casted children based on the method of restraint. Restraint modalities which place the child forward facing with

  16. Opportunities, threats and barriers to enacting mandatory child car restraint laws in Iran.

    Science.gov (United States)

    Soori, Hamid; Ainy, Elaheh; Bazargan-Hejazi, Shahrzad

    2015-01-01

    Approximately one-third of Iranian children's deaths are caused by injuries. Of these, 36% result from road traffic injuries (RTIs). Both RTIs and fatalities could be reduced by using child car restraints (CCRs). Despite their demonstrated effectiveness, CCRs are not mandatory in Iran. This study was conducted to assess opportunities and barriers in enacting mandatory CCR laws in that country. Using mixed method research, a phenomenological approach was used to explore the experiences and perspectives of road safety stakeholders in regard to opportunities and threats in enacting mandatory CCR laws in Iran. The themes derived from group discussions were used to first develop a structured questionnaire, which was later distributed to and completed by study participants. The study analysis was conducted using scores and rankings from the responses to these questions. Twenty-eight stakeholders participated in the study. Most were male, aged 36.7 ± 5.6 (range 25-59). In terms of identifying the organization that should establish mandatory CCR laws, the Traffic Police Department achieved the highest score of 90 (range 0-100). The participants also thought that the Traffic Police department is responsible to monitor compliance and conduct follow-up investigations (score = 100). In regard to existing barriers in enacting CCR laws, the lack of positive Publicity by mass media and the lack of related laws received scores of 85 and 70, respectively. Enabling factors and opportunities included 'positive regards or attitude of families towards their child's health,' 'officials' commitment to support such laws' and 'having adequate resources to raise community awareness of the importance of CCR use. These received scores of 83, 69 and 68, respectively. The results suggest that cooperation and collaboration among stakeholders including the Traffic Police, families and local communities are needed to maximize the likelihood of mandating CCR laws.

  17. Observational study of child restraining practice on Norwegian high-speed roads: restraint misuse poses a major threat to child passenger safety.

    Science.gov (United States)

    Skjerven-Martinsen; Naess, P A; Hansen, T B; Staff, T; Stray-Pedersen, A

    2013-10-01

    Restraint misuse and other occupant safety errors are the major cause of fatal and, severe injuries among child passengers in motor vehicle collisions. The main objectives of the present, study were to provide estimates of restraining practice among children younger than 16 years, traveling on Norwegian high-speed roads, and to uncover the high-risk groups associated with, restraint misuse and other safety errors. A cross-sectional observational study was performed in conjunction with regular traffic, control posts on high-speed roads. The seating and restraining of child occupants younger than 16, years were observed, the interior environment of the vehicles was examined, and a structured, interview of the driver was conducted according to a specific protocol. In total, 1260 child occupants aged 0-15 years were included in the study. Misuse of restraints, was observed in 38% of cases, with this being severe or critical in 24%. The presence of restraint, misuse varied significantly with age (psystem. Moreover, 24% of the children were seated in, vehicles with heavy, unsecured objects in the passenger compartment and/or the trunk that were, likely to move into the compartment upon impact and cause injury. No totally unrestrained children, were observed. This study provides a detailed description of the characteristics of restraint misuse and, the occupant's exposure to unsecured objects. Future education and awareness campaigns should, focus on children aged Information campaigns should also advocate the use, of chest clips and address the potential risks of hard, heavy objects in the passenger compartment and, the importance of the placement and strapping of heavy objects in the trunk. Copyright © 2013 Elsevier Ltd. All rights reserved.

  18. High levels of incorrect use of car seat belts and child restraints in Fife--an important and under-recognised road safety issue.

    Science.gov (United States)

    Campbell, H; Macdonald, S; Richardson, P

    1997-03-01

    To pilot data collection instruments and to make a preliminary estimate of the level of incorrect use of car seat belts and child restraints in Fife, Scotland. Cross sectional survey of cars containing adults and children at a number of public sites across Fife in 1995 to assess use of car occupant restraints. Trained road safety officers assessed whether seat restraints were appropriate for the age of the passengers and whether restraints were used correctly. These assessments were based on standards published by the Child Accident Prevention Trust. The survey gathered data from 596 occupants in 180 cars: 327 adults and 269 children. Ten per cent of drivers who were approached refused to participate. Car occupant restraint was assessed in 180 drivers, 151 front seat passengers, and 265 rear seat passengers. Three hundred and sixty one occupants wore seat belts, 68 were restrained by a seat belt and booster cushion, 63 in toddler seats, 25 in two way seats, and 18 in rear facing infant carriers. Ninety seven per cent of drivers, 95% of front seat passengers, and 77% of rear seat passengers were restrained. However, in 98 (52%) vehicles at least one passenger was restrained by a device that was used incorrectly. Seven per cent of adults and 28% of children were secured incorrectly. The commonest errors were loose seat belts and restraint devices not adequately secured to the seat. Rates of incorrect use were highest in child seat restraints, reaching 60% with two way seats and 44% with rear facing infant seats. The incorrect use of car occupant restraints is an under-recognised problem, both by health professionals, and the general public. Incorrect use has been shown to reduce the effectiveness of restraints, can itself result in injury, and is likely to be an important factor in child passenger injuries. The correct use of car seat restraints merits greater attention in strategies aiming to reduce road traffic casualties. Areas of intervention that could be

  19. An investigation of child restraint/seatbelt usage in motor vehicles by Maori in Northland New Zealand

    Science.gov (United States)

    Brewin, M; Peters, T

    2003-01-01

    Method: Observational surveys were conducted at the two main car parks (McDonald's and the largest supermarket) to determine the number of passengers restrained, the type of restraints, and correct use. Observations were restricted to those who were obviously Maori, based upon the local knowledge of the observer. In addition, face to face questionnaires were administered to Maori whanau/caregivers involved in the care of two or more children for more than three days a week. Results: A total of 788 participants were observed. Babies were those most likely to have all occupants restrained correctly (97%), followed by toddlers (66%), adults (56%), and school age children (48%); 138 interviews were conducted. Females (86%) were significantly more likely to ensure that all passengers were restrained on short journeys compared to males (67%; p<0.05). Respondents under 45 (80%) were significantly less likely to restrain child passengers compared to people aged 45 or older (91%; p<0.05). Discussion: This study highlights the problem that larger families in this study had in providing correct child restraints for all their children. PMID:12642567

  20. The evaluation of integrating physical restraint report and care record system.

    Science.gov (United States)

    Hou, I-Ching; Chen, Jimmy; Lin, Fan-Lian; Yu, Hui-Zu; Huang, Si-Fen; Huang, Yue-Jiao

    2013-01-01

    Physical restraint is the nursing intervention to protect patient safety in the hospital. Nurses should monitor and charting during the physical restraint period. Physical restraint is also the measurement of Taiwan clinical performance indicator. The traditional physical restraint quality measurement depends on the nurses' report. Lacking of integrating of report and nurses' care record induces the low report rate. In 2007, we developed the integrating physical restraint report and care record system to facilitate the report process in 2300-bed medical center in northern Taiwan. We evaluated the system with two methods after system implemented for one year. The results show it significantly increased the reporting rate from before (0.77%) to after (1.5%) and had no significance difference with the average reporting rate in Taiwan (P>0.05). Most nurses felt nature to satisfy on the system usefulness (81%) and preferred to use system then use paper form record (83.1%). Almost every nurse had correct cognitions on report physical restrain event when it occurred to patients. The system seemed to be successful implemented and helpful for the quality measurement management.

  1. Improving Working Conditions for Astronauts: An Electronic Personal Restraint System for Use in Microgravity Environments

    Directory of Open Access Journals (Sweden)

    Kevin Tait

    2012-01-01

    Full Text Available While in microgravity, astronauts are preoccupied with physical restraint, which takes attention away from the maintenance task or scientific experiment at hand. This may directly lead to safety concerns and increased time for extravehicular activity, as well as potentially inhibit or corrupt data collection. A primary concern is the time it takes to manipulate the current restraint system. The portable foot restraint currently in use by NASA employs a series of pins in order to engage the system or release in an emergency. This requires considerable time for the user to detach, and there is an increased risk of entanglement. If restraint operating time could be reduced by 50%, the astronaut’s assigned experiment time could be increased an average of 100 minutes per mission. Another problem identified by NASA included the inability of the current system to release the user upon failure. Research and design was conducted following the Six-Sigma DMEDI project architecture, and a new form of restraint to replace the existing system was proposed. The research team first studied the customer requirements and relevant standards set by NASA, and with this information they began drafting designs for a solution. This project utilized electromagnetism to restrain a user in microgravity. The proposed system was capable of being manipulated quickly, failing in a manner that released the user, and being electronically controlled. This active electronic control was a new concept in restraint systems, as it enabled an astronaut to effectively “walk” along a surface while remaining restrained to it. With the design prototype and a limited budget, a rudimentary test assembly was built by the team, and most of NASA’s specifications were met. With recommendations from NASA, the research team concluded by developing potential material and design solutions that can be explored in the future by Purdue University or other parties.

  2. The Impact of Child Safety Restraint Status and Age in Motor Vehicle Collisions in Predicting Type and Severity of Bone Fractures and Traumatic Injuries.

    Science.gov (United States)

    Loftis, Christopher M; Sawyer, Jeffrey R; Eubanks, James W; Kelly, Derek M

    2016-01-11

    Although morbidity and mortality in children increases in motor vehicle collisions (MVC) if child restraints are not used, no data exist correlating specific injuries with proper or improper use of safety restraints or age. The purpose of this study was to evaluate correlations between childhood MVC injuries, age, and restraint status. A medical record search for pediatric patients involved in a MVC was conducted at a pediatric hospital (level 1 trauma). Charts were reviewed for demographics and injury-specific information. Patients were grouped by age, restraint use, and injuries. Nine hundred sixty-seven patients ≤12 years (average age 6.39 y) were identified. Being properly restrained was most common in all age groups except the 4- to 8-year age group in which being improperly restrained was most common. Unrestrained patients were most commonly found in the 9- to 12-year age group. A statistically significant difference was not observed for orthopaedic injuries among the restraint groups, but internal thoracic injuries, open head wound, and open upper extremity wounds were significantly more common in improperly or unrestrained patients. Improperly restrained infants had a significantly higher rate of intracranial bleeds and abrasions than those properly restrained. Unrestrained and improperly restrained 9- to 12-year olds had significantly more open head, open upper extremity, and vascular injuries. When comparing injury types with age groups, upper extremity fractures, femoral fractures, dislocations, and spinal fractures were found to be significantly higher in older children. Preventing orthopaedic injuries in older children may be accomplished by changes in regulations or automotive safety equipment. Rear-facing child safety seats could possibly be improved to prevent head trauma in the youngest patients. There is a continued need to reinforce the importance of proper use of child safety devices to parents. Knowledge of the patient's age, along with

  3. Preliminary evaluation of wheelchair occupant restraint system usage in motor vehicles.

    Science.gov (United States)

    van Roosmalen, Linda; Bertocci, Gina E; Hobson, Douglas A; Karg, Patricia

    2002-01-01

    Individuals using wheeled mobility devices (WMDs) often use them as motor vehicle seats during transportation. Wheelchair occupant restraint systems (WORSs), consisting of upper torso and pelvic restraints, are usually mounted to the structure of transit vehicles to secure individuals within their wheelchair seats. This preliminary study attempts to evaluate the use and satisfaction of currently installed vehicle-mounted WORSs for individuals using WMD as seats in motor vehicles. A survey was conducted among 33 adults who use their WMD to travel in motor vehicles. Results from the survey showed that upper torso and pelvic restraints installed in private vehicles are quick, comfortable, and easy to use. However, WORS installed in mass transit and paratransit are often uncomfortable to wear, difficult to reach, and time-consuming to use. This preliminary study documents the growing need for developing alternative WORS that are safe, comfortable, and that allow independent usage for wheelchair occupants while traveling in a motor vehicle.

  4. Misuse of restraint systems for children and adults.

    NARCIS (Netherlands)

    Schoon, C.C.

    1992-01-01

    A study is described of the use of child seats in The Netherlands. Four types are used: a) rearward facing baby seat, b) seat with harness belt, c) seat without harness belt but with a shield of foam over which the belt is strapped and d) booster cushion. Seats were examined for the way in which the

  5. Misuse of restraint systems for children in The Netherlands.

    NARCIS (Netherlands)

    Schoon, C.C. Huijskens, C.G. & Heijkamp, A.H.

    1993-01-01

    The Dutch Ministry of Transport and Public Works commissioned the SWOV Institute for Road Safety Research and TNO Road-Vehicles Research Institute to carry out a research project. The aim is to establish the extent and type of misuse of both child seats and standard seat belts. This paper deals only

  6. Effect of honey on the reproductive system of male rat offspring exposed to prenatal restraint stress.

    Science.gov (United States)

    Haron, M N; Mohamed, M

    2016-06-01

    Exposure to prenatal stress is associated with impaired reproductive function in male rat offspring. Honey is traditionally used by the Malays for enhancement of fertility. The aim of this study was to determine the effect of honey on reproductive system of male rat offspring exposed to prenatal restraint stress. Dams were divided into four groups (n = 10/group): control, honey, stress and honey + stress groups. Dams from honey and honey + stress groups received oral honey (1.2 g kg(-1) body weight) daily from day 1 of pregnancy, meanwhile dams from stress and honey + stress groups were subjected to restraint stress (three times per day) from day 11 of pregnancy until delivery. At 10 weeks old, each male rat offspring was mated with a regular oestrus cycle female. Male sexual behaviour and reproductive performance were evaluated. Then, male rats were euthanised for assessment on reproductive parameters. Honey supplementation during prenatal restraint stress significantly increased testis and epididymis weights as well as improved the percentages of abnormal spermatozoa and sperm motility in male rat offspring. In conclusion, this study might suggest that supplementation of honey during pregnancy seems to reduce the adverse effects of restraint stress on reproductive organs weight and sperm parameters in male rat offspring.

  7. Development of an Inflatable Head/Neck Restraint System for Ejection Seats

    Science.gov (United States)

    1977-02-28

    Tolerances for Cerebral Concussion From Head Impact and Whiplash in Primates, J. Biomechanics 4:13-21, 1971. 3. Schulman, M. and Hendler E.; Restraint of...in a future NAVAIRDEVCEN report. Plans have been made to conduct these tests in the near future after the fabrication of test models is completed. D E...systems, such as those in automobile air bag systems, can inflate large volume bladders within 0.05 sec after re- ceiving the initiation input signal

  8. National Child Abuse and Neglect Data System (NCANDS) Child File

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Child Abuse and Neglect Data System (NCANDS) Child File data set consists of child-specific data of all reports of maltreatment to State child...

  9. Legal restraints on dissemination of instructional materials by educational communications systems

    Science.gov (United States)

    Bernstein, N. N.

    1972-01-01

    The legal restraints on the use of electronic communications systems for dissemination of instructional materials in the United States are discussed. First the laws are examined relating to public school elementary and secondary education, with primary emphasis on selection of courses of study and instructional materials. The second part contains an examination of the copyright laws, both the copyright law now in effect and the revision thereto currently pending before the Congress of the United States.

  10. [Placement of children and adolescents following seclusion and restraint actions–a study on family-court approvals of minors in youth welfare, child and adolescent psychiatry and jail according to Para. 1631 German Civil Code].

    Science.gov (United States)

    Kölch, Michael; Vogel, Harald

    2016-01-01

    According to German law (Para. 1631b German Civil Code), the placement of children and adolescents following seclusion and restraint actions must be approved by a family court. We analyzed the family court data of a court district in Berlin (Tempelhof-Kreuzberg) concerning cases of “placement of minors” between 2008 and 2011. A total of 474 such procedures were discovered. After data clearing and correction of cases (e. g., because of emergency interventions of the youth welfare system taking children into custody according to Para. 42, German Civil Code VIII), 376 cases remained. Of these 376 procedures in the years 2008 to 2011, 127 cases concerned children and adolescents according to Para. 1631b German Civil Code, and 249 procedures were settled either by dismissal, withdrawal or by repealing the initial decision to place the child with restrain or seclusion by means of an interim order or by filing an appeal against the final decision. Of the 127 procedures, 68 concerned girls, who were on average slightly younger than boys (14.5 years vs. 15.1 years). In two thirds of the procedures, the children and adolescents were German citizens. The majority of youths involved were living at home at the time of the procedure, but in 15 % of the case the youths were homeless. Most of the adolescents were treated with restraint in child and adolescent psychiatry. The most frequently quoted reasons for seclusion were substance abuse, suicide risk and running away from home/being homeless.

  11. Correct use of safety belts and child restraint devices in cars among children in Goiânia

    Directory of Open Access Journals (Sweden)

    Roberto Medeiros de Sousa

    2014-08-01

    Full Text Available Objective:to conduct an observational study, by means of campaigns, regarding the use of child restraint devices in cars in Goiânia.Methods:this was a cross-sectional study using a convenience sample built up as cases arose. The data were gathered into an Excel spreadsheet and were analyzed descriptively and statistically (SPSS 16.0, using chi-square and taking p < 0.05 as significant.Results:in 2006, 410 cars were evaluated, and in 2010, 544 cars were evaluated. Around 85% of the occupants were using seat belts correctly at both times (p = 0.650. In 2006, it was observed that a total of 273 passengers were occupying the rear seats, while in 2010 there were 226. Among these, 178 and 170 were using seat belts, respectively, i.e. 65.2% and 75.22% (p = 0.001. In 2006, five children were occupying the front seat without using the seat belt, while in 2010, this number was 42 (p < 0.001. In 2010, it was observed that 458 vehicles were transporting children on the rear seats, and this was being done correctly in 214 vehicles, i.e. 46.72%. In 2006, of the 410 vehicles analyzed, only 90 of them (21.95% were transporting children correctly (p < 0.001. In addition, there was a difference in the variables within the year evaluated, in which transportation done correctly in the front seat was much more frequent than transportation done correctly in the rear seats, in both years (p < 0.001. Cars transported one to four children, while vans transported one to nine children. In 2006, one van transporting children irregularly was observed, while in 2010 it was done correctly in all cases.Conclusion:comparing these two years (2006 and 2010 in which data were gathered, we can conclude that changes in behavior among drivers in Goiânia have begun, with regard to safety when transporting children in vehicles, with an improvement of 25% (p < 0.001. A large part of this has come through changes in knowledge among this segment of the population, through campaigns that

  12. Characterization of pediatric wheelchair kinematics and wheelchair tiedown and occupant restraint system loading during rear impact.

    Science.gov (United States)

    Fuhrman, Susan I; Karg, Patricia; Bertocci, Gina

    2010-04-01

    This study characterizes pediatric wheelchair kinematic responses and wheelchair tiedown and occupant restraint system (WTORS) loading during rear impact. It also examines the kinematic and loading effects of wheelchair headrest inclusion in rear impact. In two separate rear-impact test scenarios, identical WC19-compliant manual pediatric wheelchairs were tested using a seated Hybrid III 6-year-old anthropomorphic test device (ATD) to evaluate wheelchair kinematics and WTORS loading. Three wheelchairs included no headrests, and three were equipped with slightly modified wheelchair-mounted headrests. Surrogate WTORS properly secured the wheelchairs; three-point occupant restraints properly restrained the ATD. All tests used a 26km/h, 11g rear-impact test pulse. Headrest presence affected wheelchair kinematics and WTORS loading; headrest-equipped wheelchairs had greater mean seatback deflections, mean peak front and rear tiedown loads and decreased mean lap belt loads. Rear-impact tiedown loads differed from previously measured loads in frontal impact, with comparable tiedown load levels reversed in frontal and rear impacts. The front tiedowns in rear impact had the highest mean peak loads despite lower rear-impact severity. These outcomes have implications for wheelchair and tiedown design, highlighting the need for all four tiedowns to have an equally robust design, and have implications in the development of rear-impact wheelchair transportation safety standards.

  13. Biomechanics of side impact injuries: evaluation of seat belt restraint system, occupant kinematics and injury potential.

    Science.gov (United States)

    Kumaresan, Srirangam; Sances, Anthony; Carlin, Fred; Frieder, Russell; Friedman, Keith; Renfroe, David

    2006-01-01

    Side impact crashes are the second most severe motor vehicle accidents resulting in serious and fatal injuries. One of the occupant restraint systems in the vehicle is the three point lap/shoulder harness. However, the lap/shoulder restraint is not effective in a far-side crash (impact is opposite to the occupant location) since the occupant may slip out of the shoulder harness. The present comprehensive study was designed to delineate the biomechanics of far-side planar crashes. The first part of the study involves a car-to-car crash to study the crash dynamics and occupant kinematics; the second part involves an epidemiological analysis of NASS/CDS 1988-2003 database to study the distribution of serious injury; the third part includes the mathematical MADYMO analysis to study the occupant kinematics in detail; and the fourth part includes an in-depth analysis of a real world far-side accident to delineate the injury mechanism and occupant kinematics. Results indicate that the shoulder harness is ineffective in far-side crashes. The upper torso of the belted driver dummy slips out of the shoulder harness and interacted with the opposite vehicle interior such as the door panel. The unbelted occupants had a similar head injury severity pattern compared to belted occupants. The present study is another step to advance towards better understanding of the prevention, treatment and rehabilitation of side impact injuries.

  14. Optimizing the passenger air bag of an adaptive restraint system for multiple size occupants.

    Science.gov (United States)

    Bai, Zhonghao; Jiang, Binhui; Zhu, Feng; Cao, Libo

    2014-01-01

    The development of the adaptive occupant restraint system (AORS) has led to an innovative way to optimize such systems for multiple size occupants. An AORS consists of multiple units such as adaptive air bags, seat belts, etc. During a collision, as a supplemental protective device, air bags can provide constraint force and play a role in dissipating the crash energy of the occupants' head and thorax. This article presents an investigation into an adaptive passenger air bag (PAB). The purpose of this study is to develop a base shape of a PAB for different size occupants using an optimization method. Four typical base shapes of a PAB were designed based on geometric data on the passenger side. Then 4 PAB finite element (FE) models and a validated sled with different size dummy models were developed in MADYMO (TNO, Rijswijk, The Netherlands) to conduct the optimization to obtain the best baseline PAB that would be used in the AORS. The objective functions-that is, the minimum total probability of injuries (∑Pcomb) of the 5th percentile female and 50th and 95th percentile male dummies-were adopted to evaluate the optimal configurations. The injury probability (Pcomb) for each dummy was adopted from the U.S. New Car Assessment Program (US-NCAP). The parameters of the AORS were first optimized for different types of PAB base shapes in a frontal impact. Then, contact time duration and force between the PAB and dummy head/chest were optimized by adjusting the parameters of the PAB, such as the number and position of tethers, lower the Pcomb of the 95th percentile male dummy. According to the optimization results, 4 typical PABs could provide effective protection to 5th and 50th percentile dummies. However, due to the heavy and large torsos of the 95th percentile occupants, the current occupant restraint system does not demonstrate satisfactory protective function, particularly for the thorax.

  15. 78 FR 33150 - RECARO Child Safety, LLC, Receipt of Petition for Decision of Inconsequential Noncompliance

    Science.gov (United States)

    2013-06-03

    ... brand ProSport child restraint systems produced between June 16, 2010 and January 31, 2013, do not fully... approximately 39,181 RECARO brand ProSport child restraint systems produced between June 16, 2010 and January 31... , including any personal information provided. Documents submitted to a docket may be viewed by anyone at...

  16. Development and application of the Manned Maneuvering Unit, work restraint system, stowage container and return line tether

    Science.gov (United States)

    Bergonz, F. H.; Okelly, J. K.; Whitsett, C. W.; Petynia, W. W.

    1981-01-01

    The Manned Maneuvering Unit (MMU), a self-contained zero-gravity backpack designed for astronaut extravehicular activity, is discussed with reference to the system requirements and characteristics, and potential near-term and future uses. Attention is given to the MMU man-machine interfaces, propulsion capability, attitude control, crew restraint hardware, donning, doffing, activation, and deactivation. Specific applications discussed include: spacecraft inspection and servicing, assembly of large space systems, payload deployment/retrieval, and crew rescue.

  17. Restraint use in motor vehicle crash fatalities in children 0 year to 9 years old.

    Science.gov (United States)

    Lee, Lois K; Farrell, Caitlin A; Mannix, Rebekah

    2015-09-01

    Despite improvements in child passenger safety legislation and equipment, motor vehicle crashes (MVCs) continue to be the leading cause of death in children younger than 10 years. The objective of this study was to describe factors associated with restraint use in fatal MVC in children 0 year to 9 years old. The Fatality Analysis Reporting System, maintained by the National Highway Transportation Safety Administration, was used to obtain data on MVC fatalities from 2001 to 2010 in children 0 year to 9 years old. The main outcome was restraint use. Demographic information (age, sex, and race) and crash characteristics including vehicle type (sedan, van, truck, sports utility vehicle) and seat position in the vehicle were analyzed with the χ statistic to evaluate these factors for any restraint use compared with no restraint use in MVC fatalities. There were 7,625 MVC fatalities in children 0 year to 9 years old from 2001 to 2010.Among these fatalities, 4,041 (53%) had any restraint use. Front seat passengers accounted for 20.9% (1,595 of 7,625) of the fatalities. Children 0 year to 3 years old had a higher proportion of restraint use than children 4 years to 9 years old (p passenger safety to improve proper restraint use and to decrease MVC fatalities in children. Prognostic/epidemiologic study, level II.

  18. Effectiveness of six core strategies based on trauma informed care in reducing seclusions and restraints at a child and adolescent psychiatric hospital.

    Science.gov (United States)

    Azeem, Muhammad Waqar; Aujla, Akashdeep; Rammerth, Michelle; Binsfeld, Gary; Jones, Robert B

    2011-02-01

      The purpose of the study was to determine the effectiveness of six core strategies based on trauma informed care in reducing the use of seclusion and restraints with hospitalized youth.   The hospital staff received training in March 2005 in six core strategies that are based on trauma informed care. Medical records were reviewed for youth admitted between July 2004 and March 2007. Data were collected on demographics, including age, gender, ethnicity, number of admissions, type of admissions, length of stay, psychiatric diagnosis, number of seclusions, and restraints.   Four hundred fifty-eight youth (females 276/males 182) were admitted between July 2004 and March 2007. Seventy-nine patients or 17.2% (females 44/males 35) required 278 seclusions/restraints (159 seclusions/119 restraints), with average number of episodes 3.5/patient (range 1-28). Thirty-seven children and adolescents placed in seclusion and/or restraints had three or more episodes. In the first six months of study, the number of seclusions/restraints episodes were 93 (73 seclusions/20 restraints), involving 22 children and adolescents (females 11/males 11). Comparatively, in final six months of study following the training program, there were 31 episodes (6 seclusions/25 restraints) involving 11 children and adolescents (females 7/males 4). The major diagnoses of the youth placed in seclusion and/or restraints were disruptive behavior disorders (61%) and mood disorders (52%).   This study shows downward trend in seclusions/restraints among hospitalized youth after implementation of National Association of State Mental Health Program Directors six core strategies based on trauma informed care. © 2011 Wiley Periodicals, Inc.

  19. A MATLAB-based eye tracking control system using non-invasive helmet head restraint in the macaque.

    Science.gov (United States)

    De Luna, Paolo; Mohamed Mustafar, Mohamed Faiz Bin; Rainer, Gregor

    2014-09-30

    Tracking eye position is vital for behavioral and neurophysiological investigations in systems and cognitive neuroscience. Infrared camera systems which are now available can be used for eye tracking without the need to surgically implant magnetic search coils. These systems are generally employed using rigid head fixation in monkeys, which maintains the eye in a constant position and facilitates eye tracking. We investigate the use of non-rigid head fixation using a helmet that constrains only general head orientation and allows some freedom of movement. We present a MATLAB software solution to gather and process eye position data, present visual stimuli, interact with various devices, provide experimenter feedback and store data for offline analysis. Our software solution achieves excellent timing performance due to the use of data streaming, instead of the traditionally employed data storage mode for processing analog eye position data. We present behavioral data from two monkeys, demonstrating that adequate performance levels can be achieved on a simple fixation paradigm and show how performance depends on parameters such as fixation window size. Our findings suggest that non-rigid head restraint can be employed for behavioral training and testing on a variety of gaze-dependent visual paradigms, reducing the need for rigid head restraint systems for some applications. While developed for macaque monkey, our system of course can work equally well for applications in human eye tracking where head constraint is undesirable. Copyright © 2014. Published by Elsevier B.V.

  20. Mechanical restraint in psychiatry

    DEFF Research Database (Denmark)

    Bak, Jesper; Zoffmann, Vibeke; Sestoft, Dorte Maria;

    2014-01-01

    PURPOSE: To examine how potential mechanical restraint preventive factors in hospitals are associated with the frequency of mechanical restraint episodes. DESIGN AND METHODS: This study employed a retrospective association design, and linear regression was used to assess the associations. FINDING...

  1. Physical Restraint in School

    Science.gov (United States)

    Ryan, Joseph B.; Peterson, Reece L.

    2004-01-01

    The current emphasis on educating children in the least restrictive environment has resulted in the use of physical restraint procedures across all educational placement settings, including public schools. Since its initial use, restraint has been controversial. Professionals who use physical restraint claim that it is necessary to safely manage…

  2. A New and Innovative Use of the Thermal Knife and Kevlar Cord Components in a Restraint and Release System

    Science.gov (United States)

    Stewart, Alphonso; Brodeur, Stephen J. (Technical Monitor)

    2001-01-01

    A Kevlar cord and two thermal knives are key components in the Soar Array Restraint and Release System (SARRS) on the Microwave Anisotropy Probe (MAP) spacecraft at NASA's Goddard Space Flight Center. The SARRS uses a 25-foot (7.62 m) length Kevlar cord that encircles the spacecraft and secures the solar panels in stowed configuration for launch. Once in orbit, one of two redundantly configured thermal knives severs the Kevlar cord and permits the panels to deploy. The purpose of this paper is to present the details of the design, development test results, and the various innovations that were created during the development of this novel use of the thermal knife and Kevlar cord.

  3. A new and innovative use of the thermal knife and Kevlar cord components in a restraint and release system

    Science.gov (United States)

    Stewart, Alphonso C.

    2001-09-01

    A Kevlar cord and two thermal knives are key components in the Solar Array Restraint and Release System (SARRS) on the Microwave Anisotropy Probe (MAP) spacecraft at NASA's Goddard Space Flight Center. The SARRS uses a 25-foot (7.62 m) length Kevlar cord that encircles the spacecraft and secures the solar panels in stowed configuration for launch. Once in orbit, one of two redundantly configured thermal knives severs the Kevlar cord and permits the panels to deploy. The purpose of this paper is to present the details of the design, development test results, and the various innovations that were created during the development of this novel use of the thermal knife and Kevlar cord.

  4. Iowa Child Care Quality Rating System: QRS Profile. The Child Care Quality Rating System (QRS) Assessment

    Science.gov (United States)

    Child Trends, 2010

    2010-01-01

    This paper presents a profile of Iowa's Child Care Quality Rating System prepared as part of the Child Care Quality Rating System (QRS) Assessment Study. The profile is divided into the following categories: (1) Program Information; (2) Rating Details; (3) Quality Indicators for Center-Based Programs; (4) Indicators for Family Child Care Programs;…

  5. 49 CFR 571.225 - Standard No. 225; Child restraint anchorage systems.

    Science.gov (United States)

    2010-10-01

    ... parallel to the vehicle's vertical longitudinal plane through the X point on the test device, and, (2...) Applied— (1) In a forward direction parallel to the vehicle's longitudinal vertical plane, and (2... parallel to the vehicle's longitudinal centerline; (2) Initially, along a horizontal line or along any...

  6. 78 FR 55629 - Special Conditions: Cirrus Design Corporation, Model SF50; Inflatable Three-Point Restraint...

    Science.gov (United States)

    2013-09-11

    ... restraints are standard in the automotive industry, the use of an inflatable restraint system is novel for... potential for head and torso injury. The inflatable restraint behaves in a manner similar to an automotive... should not increase the risk already associated with fire. Therefore, the inflatable restraint should be...

  7. Time to death analysis of road traffic accidents in relation to delta V, drunk driving, and restraint systems.

    Science.gov (United States)

    Ju, Yonghan; Sohn, So Young

    2014-01-01

    The main goal of this research is to identify variables related to the expected time to death due to road traffic accidents (RTAs). Such research is expected to be useful in improving safety laws and regulations and developing new safety systems. The resulting information is crucial not only for reducing accident fatalities but for assessing related insurance policies. In this article, we analyze factors that are potentially associated with variation in the expected survival time after a road traffic accident using Weibull regression. In particular, we consider the association with alcohol involvement, delta V, and restraint systems. Our empirical results, obtained based on the NASS-CDS, indicate that the expected survival time for non-alcohol-impaired drivers is 3.23 times longer at a delta V of 50 km/h than that for alcohol-impaired drivers under the same conditions. In addition, it was observed that, even when occupants were alcohol-impaired, if they were protected by both air bags and seat belts, their expected survival time after an RTA increased 2.59-fold compared to alcohol-impaired drivers who used only seat belts. Our findings may be useful in improving road traffic safety and insurance policies by offering insights into the factors that reduce fatalities.

  8. Comprehensive Child Welfare Information System. Final rule.

    Science.gov (United States)

    2016-06-01

    This final rule replaces the Statewide and Tribal Automated Child Welfare Information Systems (S/TACWIS) rule with the Comprehensive Child Welfare Information System (CCWIS) rule. The rule also makes conforming amendments in rules in related requirements. This rule will assist title IV-E agencies in developing information management systems that leverage new innovations and technology in order to better serve children and families. More specifically, this final rule supports the use of cost-effective, innovative technologies to automate the collection of high-quality case management data and to promote its analysis, distribution, and use by workers, supervisors, administrators, researchers, and policy makers.

  9. The role of galanin system in modulating depression, anxiety, and addiction-like behaviors after chronic restraint stress.

    Science.gov (United States)

    Zhao, X; Seese, R R; Yun, K; Peng, T; Wang, Z

    2013-08-29

    There is high comorbidity between stress-related psychiatric disorders and addiction, suggesting they may share one or more common neurobiological mechanisms. Because of its role in both depressive and addictive behaviors, the galanin system is a strong candidate for such a mechanism. In this study, we tested if galanin and its receptors are involved in stress-associated behaviors and drug addiction. Mice were exposed to 21 days of chronic restraint stress (CRS); subsequently, mRNA levels of galanin, galanin receptors (GalRs), the rate-limiting enzymes for the synthesis of monoamines, and monoamine autoreceptors were measured in the nucleus accumbens by a quantitative real-time polymerase chain reaction. Moreover, we tested the effects of this stress on morphine-induced addictive behaviors. We found that CRS induced anxiety and depression-like behaviors, impaired the formation and facilitated the extinction process in morphine-induced conditioned place preference (CPP), and also blocked morphine-induced behavioral sensitization. These behavioral results were accompanied by a CRS-dependent increase in the mRNA expression of galanin, GalR1, tyrosine hydroxylase (TH), tryptophan hydroxylase 2, and 5-HT1B receptor. Interestingly, treatment with a commonly used antidepressant, fluoxetine, normalized the CRS-induced behavioral changes based on reversing the higher expression of galanin and TH while increasing the expression of GalR2 and α2A-adrenceptor. These results indicate that activating the galanin system, with corresponding changes to noradrenergic systems, following chronic stress may modulate stress-associated behaviors and opiate addiction. Our findings suggest that galanin and GalRs are worthy of further exploration as potential therapeutic targets to treat stress-related disorders and drug addiction.

  10. Children with special physical health care needs: restraint use and injury risk in motor vehicle crashes.

    Science.gov (United States)

    Huang, Patty; Kallan, Michael J; O'Neil, Joseph; Bull, Marilyn J; Blum, Nathan J; Durbin, Dennis R

    2011-10-01

    Physical disabilities may affect a child passenger's fit within a conventional motor vehicle restraint. The aim of this study is to describe and compare injury risk in motor vehicle crashes (MVC) among children with and without special physical health care needs (SPHCN). This analysis, conducted in 2007-2008, utilizes data collected between December 1998 and November 2002 in a cross-sectional study of children ≤15 years old involved in crashes of State-Farm insured vehicles in 15 states and the District of Columbia. Parent reports via telephone survey were used to define pre-crash SPHCN, restraint status, and occurrence of significant injuries using a validated survey. Complete data were collected for 18,852 children aged 0-15 years; 159 children were reported to have a SPHCN (0.8% and 0.7% of children aged 0-8 and 9-15 years, respectively). A greater proportion of children with SPHCN aged 0-8 years were appropriately restrained (P < 0.001), but there was no significant difference in restraint use among children with and without SPHCN aged 9-15 years. There was no significant association between the presence of a SPHCN and injury risk in either age group, after adjustment for child/driver characteristics (children aged 0-8 years: OR 1.27, 95% CI: 0.48-3.33; children aged 9-15 years: OR 1.51, 95% CI: 0.38-6.11). Children with and without SPHCN have similar injury risk in MVC, despite increased age-appropriate restraint usage among children aged 0-8 years. When counseling families about vehicle safety, practitioners should consider the fit of a child with SPHCN in a restraint system.

  11. [Physical restraint and procedure].

    Science.gov (United States)

    Van de Vyvere, A; Dumont, C

    2013-09-01

    The widespread practice of physical restraint of the elderly has used in most case in order to protect elders against injuries after falls or to manage behaviour agitation during delirium for example. However, "protect" isn't correct because of the adverse effects have been reported as falls increase, pressures sores, depression, aggression and death. In fact, efficacy of restraints for safeguarding patients from injury has not been demonstrated clinically. This paper reviews the current medico-legal knowledge regarding physical restraint use in this frail population and suggests some considerations about ethical practice and procedure evaluation.

  12. The influence of personal protection equipment, occupant body size, and restraint system on the frontal impact responses of Hybrid III ATDs in tactical vehicles.

    Science.gov (United States)

    Zaseck, Lauren Wood; Orton, Nichole Ritchie; Gruber, Rebekah; Rupp, Jonathan; Scherer, Risa; Reed, Matthew; Hu, Jingwen

    2017-08-18

    Although advanced restraint systems, such as seat belt pretensioners and load limiters, can provide improved occupant protection in crashes, such technologies are currently not utilized in military vehicles. The design and use of military vehicles presents unique challenges to occupant safety-including differences in compartment geometry and occupant clothing and gear-that make direct application of optimal civilian restraint systems to military vehicles inappropriate. For military vehicle environments, finite element (FE) modeling can be used to assess various configurations of restraint systems and determine the optimal configuration that minimizes injury risk to the occupant. The models must, however, be validated against physical tests before implementation. The objective of this study was therefore to provide the data necessary for FE model validation by conducting sled tests using anthropomorphic test devices (ATDs). A secondary objective of this test series was to examine the influence of occupant body size (5th percentile female, 50th percentile male, and 95th percentile male), military gear (helmet/vest/tactical assault panels), seat belt type (3-point and 5-point), and advanced seat belt technologies (pretensioner and load limiter) on occupant kinematics and injury risk in frontal crashes. In total, 20 frontal sled tests were conducted using a custom sled buck that was reconfigurable to represent both the driver and passenger compartments of a light tactical military vehicle. Tests were performed at a delta-V of 30 mph and a peak acceleration of 25 g. The sled tests used the Hybrid III 5th percentile female, 50th percentile male, and 95th percentile male ATDs outfitted with standard combat boots and advanced combat helmets. In some tests, the ATDs were outfitted with additional military gear, which included an improved outer tactical vest (IOTV), IOTV and squad automatic weapon (SAW) gunner with a tactical assault panel (TAP), or IOTV and rifleman with

  13. 75 FR 71648 - Federal Motor Vehicle Safety Standards, Child Restraint Systems; Hybrid III 10-Year-Old Child...

    Science.gov (United States)

    2010-11-24

    ... No. 213 test environment. \\27\\ Arbogast, K B, et al., ``Predictors of Pediatric Abdominal Injury Risk... slides under the lap belt in a frontal impact. As a result, the belt can enter the abdominal region and... becomes more horizontal and reclined because the overwhelming majority of the dummy's mass is below the...

  14. Rating child passenger safety laws relative to best practice recommendations for occupant protection.

    Science.gov (United States)

    Klinich, Kathleen D; Benedetti, Marco; Manary, Miriam A; Flannagan, Carol A

    2017-05-19

    State laws regarding child passenger protection vary substantially. The objective of this study was to develop a scoring system to rate child passenger safety laws relative to best practice recommendations for each age of child. State child passenger safety and seat belt laws were retrieved from the LexisNexis database for the years 2002-2015. Text of the laws was reviewed and compared to current best practice recommendations for child occupant protection for each age of child. A 0-4 scale was developed to rate the strength of the state law relative to current best practice recommendations. A rating of 3 corresponds to a law that requires a restraint that is sufficient to meet best practice, and a rating of 4 is given to a law that specifies several options that would meet best practice. Scores of 0, 1, or 2 are given to laws requiring less than best practice to different degrees. The same scale is used for each age of child despite different restraint recommendations for each age. Legislation that receives a score of 3 requires rear-facing child restraints for children under age 2, forward-facing harnessed child restraints for children aged 2 to 4, booster seats for children 5 to 10, and primary enforcement of seat belt use in all positions for children aged 11-13. Legislation requiring use of a "child restraint system according to instructions" would receive a score of 1 for children under age 2 and a 2 for children aged 2-4 because it would allow premature use of a booster for children weighing more than 13.6 kg (30 lb). The scoring system developed in this study can be used in mathematical models to predict how child passenger safety legislation affects child restraint practices.

  15. Physical restraint and procedure

    National Research Council Canada - National Science Library

    Van de Vyvere, A; Dumont, C

    2013-01-01

    The widespread practice of physical restraint of the elderly has used in most case in order to protect elders against injuries after falls or to manage behaviour agitation during delirium for example...

  16. National Child Abuse and Neglect Data System Glossary

    Science.gov (United States)

    ... Data System Glossary Listen Child Abuse and Neglect Data System Glossary Published: March 31, ... This document is the glossary for the National Child Abuse and Neglect Data System (NCANDS), including terms from ...

  17. A restraint-free small animal SPECT imaging system with motion tracking

    Energy Technology Data Exchange (ETDEWEB)

    Weisenberger, A.G.; Gleason, S.S.; Goddard, J.; Kross, B.; Majewski, S.; Meikle, S.R.; Paulus, M.J.; Pomper, M.; Popov, V.; Smith, M.F.; Welch, B.L.; Wojcik, R.

    2005-06-01

    We report on an approach toward the development of a high-resolution single photon emission computed tomography (SPECT) system to image the biodistribution of radiolabeled tracers such as Tc-99m and I-125 in unrestrained/unanesthetized mice. An infrared (IR)-based position tracking apparatus has been developed and integrated into a SPECT gantry. The tracking system is designed to measure the spatial position of a mouse's head at a rate of 10-15 frames per second with submillimeter accuracy. The high-resolution, gamma imaging detectors are based on pixellated NaI(Tl) crystal scintillator arrays, position-sensitive photomultiplier tubes, and novel readout circuitry requiring fewer analog-digital converter (ADC) channels while retaining high spatial resolution. Two SPECT gamma camera detector heads based upon position-sensitive photomultiplier tubes have been built and installed onto the gantry. The IR landmark-based pose measurement and tracking system is under development to provide animal position data during a SPECT scan. The animal position and orientation data acquired by the tracking system will be used for motion correction during the tomographic image reconstruction.

  18. TRIO Platform: A novel low profile in vivo imaging support and restraint system for mice

    Directory of Open Access Journals (Sweden)

    Vladislav eVoziyanov

    2016-04-01

    Full Text Available High resolution, in vivo optical imaging of the mouse brain over time often requires anesthesia, which necessitates maintaining the animal's body temperature and level of anesthesia, as well as securing the head in an optimal, stable position. Controlling each parameter usually requires using multiple systems. Assembling multiple components into the small space on a standard microscope stage can be difficult and some commercially available parts simply do not fit. Furthermore, it is time-consuming to position an animal in the identical position over multiple imaging sessions for longitudinal studies. This is especially true when using an implanted gradient index (GRIN lens for deep brain imaging. The multiphoton laser beam must be parallel with the shaft of the lens because even a slight tilt of the lens can degrade image quality. In response to these challenges, we have designed a compact, integrated in vivo imaging support system to overcome the problems created by using separate systems during optical imaging in mice. It is a single platform that provides (1 sturdy head fixation, (2 an integrated gas anesthesia mask, and (3 safe warm water heating. This THREE-IN-ONE (TRIO Platform has a small footprint and a low profile that positions a mouse’s head only 20 mm above the microscope stage. This height is about one half to one third the height of most commercially available immobilization devices. We have successfully employed this system, using isoflurane in over 40 imaging sessions with an average of 2 h per session with no leaks or other malfunctions. Due to its smaller size, the TRIO Platform can be used with a wider range of upright microscopes and stages. Most of the components were designed in SOLIDWORKS® and fabricated using a 3D printer. This additive manufacturing approach also readily permits size modifications for creating systems for other small animals.

  19. TRIO Platform: A Novel Low Profile In vivo Imaging Support and Restraint System for Mice.

    Science.gov (United States)

    Voziyanov, Vladislav; Kemp, Benjamin S; Dressel, Chelsea A; Ponder, Kayla; Murray, Teresa A

    2016-01-01

    High resolution, in vivo optical imaging of the mouse brain over time often requires anesthesia, which necessitates maintaining the animal's body temperature and level of anesthesia, as well as securing the head in an optimal, stable position. Controlling each parameter usually requires using multiple systems. Assembling multiple components into the small space on a standard microscope stage can be difficult and some commercially available parts simply do not fit. Furthermore, it is time-consuming to position an animal in the identical position over multiple imaging sessions for longitudinal studies. This is especially true when using an implanted gradient index (GRIN) lens for deep brain imaging. The multiphoton laser beam must be parallel with the shaft of the lens because even a slight tilt of the lens can degrade image quality. In response to these challenges, we have designed a compact, integrated in vivo imaging support system to overcome the problems created by using separate systems during optical imaging in mice. It is a single platform that provides (1) sturdy head fixation, (2) an integrated gas anesthesia mask, and (3) safe warm water heating. This THREE-IN-ONE (TRIO) Platform has a small footprint and a low profile that positions a mouse's head only 20 mm above the microscope stage. This height is about one half to one third the height of most commercially available immobilization devices. We have successfully employed this system, using isoflurane in over 40 imaging sessions with an average of 2 h per session with no leaks or other malfunctions. Due to its smaller size, the TRIO Platform can be used with a wider range of upright microscopes and stages. Most of the components were designed in SOLIDWORKS® and fabricated using a 3D printer. This additive manufacturing approach also readily permits size modifications for creating systems for other small animals.

  20. Gold Mine or Minefield: Understanding Russian Law on Vertical Restraints

    Directory of Open Access Journals (Sweden)

    Valentina Rucker

    2015-02-01

    Full Text Available While the Russian Federation represents a significant opportunity for growth, that opportunity is coupled with serious risks. As it relates to managing product distribution, Russian vertical restraint law remains significantly more restrictive than that of the U.S. and, since unless a company is fully integrated, it must manage its distribution system by way of vertical agreements, presents a large problem for businesses seeking to conduct business in Russia. While Russia has made significant steps in the right direction, the lack of consistent application of economic analysis to evaluation of vertical restraints leaves companies exposed. Further, the sometimes inconsistent application of the laws also makes it hard to predict how any particular vertical agreement would be evaluated. Neither American nor Russian antitrust laws establish a list of possible vertical restraints. Thus, there is no exhaustive guidance regarding how these restraints should be treated. U.S. antitrust laws, however, generally place all vertical restraints into one of two categories, intrabrand restraints and interbrand restraints. Intrabrand restraints are those that restrain the downstream firm’s freedom with regard to the resale of the product at issue (distribution restrictions. Interbrand restraints are those that restrict a downstream or upstream firm’s freedom to deal with competitors of the firm imposing the restraint (interbrand restrictions. It should be noted that Russian law does not make this distinction.

  1. Gold Mine or Minefield: Understanding Russian Law on Vertical Restraints

    Directory of Open Access Journals (Sweden)

    Valentina Rucker

    2014-01-01

    Full Text Available While the Russian Federation represents a significant opportunity for growth, that opportunity is coupled with serious risks. As it relates to managing product distribution, Russian vertical restraint law remains significantly more restrictive than that of the U.S. and, since unless a company is fully integrated, it must manage its distribution system by way of vertical agreements, presents a large problem for businesses seeking to conduct business in Russia. While Russia has made significant steps in the right direction, the lack of consistent application of economic analysis to evaluation of vertical restraints leaves companies exposed. Further, the sometimes inconsistent application of the laws also makes it hard to predict how any particular vertical agreement would be evaluated. Neither American nor Russian antitrust laws establish a list of possible vertical restraints. Thus, there is no exhaustive guidance regarding how these restraints should be treated. U.S. antitrust laws, however, generally place all vertical restraints into one of two categories, intrabrand restraints and interbrand restraints. Intrabrand restraints are those that restrain the downstream firm’s freedom with regard to the resale of the product at issue (distribution restrictions. Interbrand restraints are those that restrict a downstream or upstream firm’s freedom to deal with competitors of the firm imposing the restraint (interbrand restrictions. It should be noted that Russian law does not make this distinction.

  2. A critical analysis of the fatal injuries resulting from the Continental flight 1713 airline disaster: evidence in favor of improved passenger restraint systems.

    Science.gov (United States)

    Lillehei, K O; Robinson, M N

    1994-11-01

    To examine the mechanisms of injury and death in a commercial airline disaster and to propose preventative safety measures based on this analysis. Denver County Coroner's Office and the National Transportation Safety Board. Those patients suffering fatal injuries as a result of the Continental Flight 1713 Airline crash. Autopsy records from the Denver County Coroner's Office were reviewed with the causes of death determined. In many instances there was significant injury to more than one anatomic region in a single individual, each analyzed independently. There were 28 fatalities: nine died of mechanical asphyxiation, one of a penetrating cranial injury, and 18 of blunt trauma. The blunt injuries were remarkably similar to the deceleration injuries seen in high-speed motor vehicle crashes. Head trauma was the most common fatal blunt injury, followed by injuries to the chest and the abdomen. Thirty-six percent of the head injuries and 27% of the chest injuries had associated cervical and thoracic spine fractures, respectively. Analysis revealed a marked similarity in injury pattern sustained by seatmates, with a high incidence of fatal and serious injuries suffered by those passengers sitting in the front half of the airplane. Fatal blunt injury secondary to deceleration forces was the most common cause of death seen in this analysis. The use of a lap belt restraint system alone is not adequate to protect passengers against these forces as shown convincingly in the automotive industry literature. What impact a better passenger restraint system may have had on survival in this disaster is unknown, however, at a minimum, it would have significantly improved survival for 6 of 28 passengers dying of isolated blunt head trauma. Minor alterations in aircraft design (secure bolting of passenger seats to the airplane superstructure) and passenger restraints (3-point lap and shoulder harness system) is proposed to positively influence survival during an airplane crash at

  3. Special Purpose Crew Restraints for Teleoperation

    Science.gov (United States)

    Whitmore, Mihriban; Holden, Kritina; Norris, Lena

    2004-01-01

    With permanent human presence onboard the International Space Station (ISS), and long duration space missions being planned for the moon and Mars, humans will be living and working in microgravity over increasingly long periods of time. In addition to weightlessness, the confined nature of a spacecraft environment results in ergonomic challenges such as limited visibility, and access to the activity area. These challenges can result in prolonged periods of unnatural postures for the crew, ultimately causing pain, injury, and loss of productivity. Determining the right set of human factors requirements and providing an ergonomically designed environment is crucial to mission success. While a number of general purpose restraints have been used on ISS (handrails, foot loops), experience has shown that these general purpose restraints may not be optimal, or even acceptable for some tasks that have unique requirements. For example, some onboard activities require extreme stability (e.g., glovebox microsurgery), and others involve the use of arm, torso and foot movements in order to perform the task (e-g. robotic teleoperation); standard restraint systems will not work in these situations. The Usability Testing and Analysis Facility (WAF) at the NASA Johnson Space Center began evaluations of crew restraints for these special situations by looking at NASAs Robonaut. Developed by the Robot Systems Technology Branch, Robonaut is a humanoid robot that can be remotely operated through a tetepresence control system by an operator. It was designed to perform work in hazardous environments (e.g., Extra Vehicular Activities). A Robonaut restraint was designed, modeled for the population, and ultimately tested onboard the KC-135 microgravity aircraft. While in microgravity, participants were asked to get in and out of the restraint from different locations, perform maximum reach exercises, and finally to teleoperate Robonaut while in the restraint. The sessions were videotaped

  4. A prospective study of children aged injuries are observed predominantly in older children and are associated with restraint misuse.

    Science.gov (United States)

    Skjerven-Martinsen, Marianne; Naess, Paal Aksel; Hansen, Trond Boye; Gaarder, Christine; Lereim, Inggard; Stray-Pedersen, Arne

    2014-12-01

    The implementation of the compulsory wearing of seat belts (SBs) for children and improvements in child restraint systems have reduced the number of deaths and severe injuries among children involved in motor vehicle (MV) collisions (MVCs). Establishing the characteristics predictive of such injuries may provide the basis for targeted safety campaigns and lead to a further reduction in mortality and morbidity among children involved in MVCs. This study performed a multidisciplinary investigation among child occupants involved in MVCs to elucidate injury mechanisms, evaluate the safety measures used and determine the characteristics that are predictive of injury. A prospective study was conducted of all child occupants aged crash victims, police reports, medical records and reconstructions. Each case was reviewed by a multidisciplinary team to assess the mechanism of injury. In total, 158 child occupants involved in 100 MVCs were investigated, of which 27 (17%) exhibited Abbreviated Injury Scale (AIS) scores of 2+ injuries and 15 (9%) exhibited AIS 3+ injuries. None of the children died. Of those with AIS 2+ injuries (n=27), 89% (n=24) were involved in frontal impact collisions and 11% (3/27) were involved in side impacts. Multivariate analysis revealed that restraint misuse, age, the prevailing lighting conditions and ΔV were all independently correlated with AIS 2+ injuries. Safety errors were found in 74% (20/27) of those with AIS 2+ injuries and 93% (14/15) of those with AIS 3+ injuries. The most common safety error was misuse of restraints, and in particular loose and/or improperly positioned SBs. The risk of injury among child occupants is significantly higher when the child occupants are exposed to safety errors within the interior of the vehicle. Future campaigns should focus on the prevention of restraint misuse and unsecured objects in the passenger compartment or boot. Copyright © 2014. Published by Elsevier Ltd.

  5. Acute Cold / Restraint Stress in Castrated Rats

    Directory of Open Access Journals (Sweden)

    Farideh Zafari Zangeneh

    2008-09-01

    Full Text Available Objective: The present study aimed to determine whether castration altered osmotically stimulated vasopressin (VP release and urinary volume and what is the role of endocrine-stress axis in this process.Materials and methods: Totally 108 mice were studied in two main groups of castrated (n=78 and control (n=30. Each group was extracted by acute cold stress (4◦C for 2h/day, restraint stress (by syringes 60cc 2h/day and cold/restraint stress. The castrated group was treated in sub groups of testosterone, control (sesame oil as vehicle of testosterone. Propranolol as blocker of sympathetic nervous system was given to both groups of castrated mice and main control.Results: Our results showed that, there is interactions between testosterone and sympathetic nervous system on vasopressin, because urine volume was decreased only in testoctomized mice with cold/restraint and cold stress (P<0.001; propranolol as the antagonist of sympathetic nervous system could block and increase urine volume in castrated mice. This increased volume of urine was due to acute cold stress, not restraint stress (p<0.001. The role of testosterone, noradrenalin (NA and Vasopressin (VP in the acute cold stress is confirmed, because testosterone could return the effect of decreased urine volume in control group (P<0.001. Conclusion: Considering the effect of cold/restraint stress on urinary volume in castrated mice shows that there is interaction between sex hormone (testosterone, vasopressin and adrenergic systems.

  6. Automobile restraints for children: a review for clinicians

    OpenAIRE

    Howard, Andrew W.

    2002-01-01

    MORE CANADIAN CHILDREN DIE OF ROAD TRAFFIC INJURIES than of any other cause. Nonuse and misuse of child restraints is common and leads to preventable severe injuries or deaths. This article, intended for clinicians interested in injury prevention counselling, advocacy, research, and treatment of child occupants in car crashes, reviews current knowledge about child safety seats and discusses controversies related to their use. Children should sit in the back seat of a vehicle and should be pro...

  7. Temporal changes of the adrenal endocrine system in a restraint stressed mouse and possibility of postmortem indicators of prolonged psychological stress.

    Science.gov (United States)

    Hayashi, Takahito; Ikematsu, Kazuya; Abe, Yuki; Ihama, Yoko; Ago, Kazutoshi; Ago, Mihoko; Miyazaki, Tetsuji; Ogata, Mamoru

    2014-07-01

    We investigated temporal changes of adrenal endocrine systems through the hypothalamic-pituitary-adrenal (HPA) and sympathetic-adrenomedullary (SA) axis in restraint stressed mice. Restraint stress for 1 day to 3 weeks caused a significant increase in serum levels of ACTH and glucocorticoids accompanied with an increase in adrenal weights, indicating activation of the HPA axis. Reflecting the overproduction of glucocorticoids, adrenal cholesterol content decreased. Moreover, adrenal gene expression involved in cholesterol supply, including scavenger receptor-class B type I, HMG-CoA reductase, and hormone-sensitive lipase, was increased over the same period. After 4 weeks stress, all of these changes returned to control levels. In contrast, adrenal gene expression of chromogranin A, which is cosecreted with catecholamine via the SA axis, was increased with 1 day to 2 weeks of stress, and decreased with 3-4 weeks of stress. Our results suggest that analyses of adrenal endocrine systems based on the combination of several markers examined here would be useful for not only proving prolonged psychological stress experience but also determining its duration.

  8. The Physical Restraint Controversy.

    Science.gov (United States)

    Mullen, Joseph K.

    2000-01-01

    Professional and government committees are examining use of physical restraints with troubled youth as a result of reports of problems with its use. Examples of what is being done to improve practice standards in area of crisis intervention include limiting how often restrictive procedures can be use; stating the technique must never negatively…

  9. Nonstructural seismic restraint guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Butler, D.M.; Czapinski, R.H.; Firneno, M.J.; Feemster, H.C.; Fornaciari, N.R.; Hillaire, R.G.; Kinzel, R.L.; Kirk, D.; McMahon, T.T.

    1993-08-01

    The Nonstructural Seismic Restraint Guidelines provide general information about how to secure or restrain items (such as material, equipment, furniture, and tools) in order to prevent injury and property, environmental, or programmatic damage during or following an earthquake. All SNL sites may experience earthquakes of magnitude 6.0 or higher on the Richter scale. Therefore, these guidelines are written for all SNL sites.

  10. Child Poverty and the Health Care System.

    Science.gov (United States)

    Racine, Andrew D

    2016-04-01

    The persistence of child poverty in the United States and the pervasive health consequences it engenders present unique challenges to the health care system. Human capital theory and empirical observation suggest that the increased disease burden experienced by poor children originates from social conditions that provide suboptimal educational, nutritional, environmental, and parental inputs to good health. Faced with the resultant excess rates of pediatric morbidity, the US health care system has developed a variety of compensatory strategies. In the first instance, Medicaid, the federal-state governmental finance system designed to assure health insurance coverage for poor children, has increased its eligibility thresholds and expanded its benefits to allow greater access to health services for this vulnerable population. A second arm of response involves a gradual reengineering of health care delivery at the practice level, including the dissemination of patient-centered medical homes, the use of team-based approaches to care, and the expansion of care management beyond the practice to reach deep into the community. Third is a series of recent experiments involving the federal government and state Medicaid programs that includes payment reforms of various kinds, enhanced reporting, concentration on high-risk populations, and intensive case management. Fourth, pediatric practices have begun to make use of specific tools that permit the identification and referral of children facing social stresses arising from poverty. Finally, constituencies within the health care system participate in enhanced advocacy efforts to raise awareness of poverty as a distinct threat to child health and to press for public policy responses such as minimum wage increases, expansion of tax credits, paid family leave, universal preschool education, and other priorities focused on child poverty.

  11. The Child Rights System in Romanian Legislation

    OpenAIRE

    OANA-CARMEN RĂVAŞ

    2008-01-01

    Child rights are a set of international conventions which define the conditions for the normal development of a child. In Romania, child rights are now the subject of a specific law, law nr. 272/2004 on the Protection and Promotion of the Rights of the Child, which is in accordance with the international conventions. All children have their own rights - whether at home with their natural parents, in foster families, child care institutions or at school. Parents and families, the professional ...

  12. Restraint use law enforcement intervention in Latino communities.

    Science.gov (United States)

    Schaechter, Judy; Uhlhorn, Susan B

    2011-11-01

    Motor vehicle crashes are the leading cause of death for U.S. Latinos aged 1 to 35 years. Restraint use is an effective means of prevention of motor vehicle crash injury. Effective interventions to raise restraint use include the following: legislation, law enforcement, education, and equipment distribution. The effects of law enforcement interventions in Latino immigrant communities are understudied. We measured the community-level effect of a combined intervention that included warnings and citations phase enforcement in Latino communities. We designed and implemented in two of three Latino-majority communities a multicomponent intervention consisting of a community awareness campaign, restraint use education with equipment distribution, and a two-staged law enforcement intervention. Restraint use observations were conducted in all three communities at baseline, after the warnings phase and again after the citations phase of the intervention were completed. The combined intervention of community awareness, education, child passenger restraint distribution, and law enforcement focused on educational traffic stops with incentives and warnings was associated with a significant increase in both driver and child passenger restraint use in one intervention community, but only driver restraint increased to a level of significance in the other intervention community; significant increase was also noted among nonintervention drivers. The citations phase of the intervention did not result in a significant increase in restraint use and was complicated by interruptions due to unlicensed drivers. The combined effort of community awareness, education, equipment distribution and law enforcement intervention that included incentives and warnings may be effective at increasing seat belt use in Latino communities without the need for citations.

  13. Child human trafficking victims: challenges for the child welfare system.

    Science.gov (United States)

    Fong, Rowena; Berger Cardoso, Jodi

    2010-08-01

    Since the passing of the Victims of Trafficking and Violence Protection Act in 2000 and its reauthorization by President George Bush in 2008, federal, state and community efforts in identifying and providing services for victims of human trafficking have significantly improved. However, most of the research and resources for trafficking victims have been directed towards adults rather than children. Researchers agree that there is a growing number of sexually exploited and trafficked children in the United States yet few programs emphasize the unique experiences and special needs of this population. This article examines commercial sexual exploitation of children; differentiates the needs and problems between child prostitution and victims of human trafficking; reviews and critiques current treatment practices; and summarizes challenges and successes in working with child victims of human trafficking, offering practice and policy recommendations.

  14. Development of an Integrated Test Bench for Automotive Occupant Restraint System%汽车乘员约束系统综合试验台的研制

    Institute of Scientific and Technical Information of China (English)

    白中浩; 徐正; 颜强; 张前斌

    2013-01-01

    Based on regulations both at home and abroad for the strength test of automotive seats and safety belt anchorage, an integrated test bench for occupant restraint system is developed, with which the tests of seat stiffness , safety belt anchorage strength and the performance of head-rest can be conducted. A FE model of the master frame of test bench is built and its strength is analyzed with software ANSYS. The control system of test bench is developed by using virtual instrument technology, and the strength test of seats assembly and safety belt anchorage are performed on the test bench. The results demonstrate that the test bed developed can meet the requirements of relevant test regulations and can be used for the research and development of automotive occupant restraint system.%基于国内外汽车座椅和安全带固定点强度试验法规,开发了可同时进行座椅刚度、安全带固定点强度测试和头枕性能等测试的乘员约束系统综合试验台.采用ANSYS软件建立了试验台主台架的有限元模型对主台架进行强度分析;应用虚拟仪器技术开发了该试验台的控制系统,并利用该试验台进行了座椅总成静强度试验和安全带固定点强度试验.结果表明,该试验台能满足相关试验法规的要求,可用于对乘员约束系统的研究和开发.

  15. Restraint use and seating position among children in motor vehicles ...

    African Journals Online (AJOL)

    and disability in children in both developed and developing countries and account for ... 100 000 population. This is double the global rate and 26% higher .... and there is no significant variation by gender, 'race', age or grade.5 In an invisible survey (the .... education and advocacy for child passenger and driver restraint in.

  16. Building Capacity for Trauma Intervention across Child-Serving Systems

    Science.gov (United States)

    Chinitz, Susan; Stettler, Erin M.; Giammanco, Denise; Silverman, Marian; Briggs, Rahil D.; Loeb, Joanne

    2010-01-01

    Infants most vulnerable to trauma are often the least able to access interventions. Universal child-serving systems, such as primary pediatrics, early care and education, and the child welfare system, can offer a port of entry for millions of children annually for trauma-related supports and services. However, practitioners in these systems have…

  17. Child Maltreatment Reporting by Educational Personnel: Implications for Racial Disproportionality in the Child Welfare System

    Science.gov (United States)

    Krase, Kathryn Suzanne

    2015-01-01

    African American children are disproportionally overrepresented in the U.S. child protection system. Because educational personnel are a significant source of reports of suspected child maltreatment across the country and in all states, the present study examines the impact of these reports on racial disproportionality and disparity at the…

  18. Social Behavior and Physical Restraints.

    Science.gov (United States)

    Folmar, Steven; Wilson, Holly

    1989-01-01

    Examined whether physical restraints are related to decreased social behavior among nursing home residents. Data collected from 112 nursing home residents suggest that low social performance puts resident at risk of being restrained, but more frequently use of restraint hampers resident's performance of social behavior. (Author/NB)

  19. Multipurpose Crew Restraints for Long Duration Space Flights

    Science.gov (United States)

    Whitmore, Mihriban; Baggerman, Susan; Ortiz, M. R.; Hua, L.; Sinnott, P.; Webb, L.

    2004-01-01

    concept based on previous flight experiences, the needs of future tasks, and crewmembers' preferences. Also, a catalog with existing IVA/EVA restraint and mobility aids has been developed. Other efforts included the ISS crew debrief data on restraints, compilation of data from MIR, Skylab and ISS on restraints, and investigating possibility of an in-flight evaluation of current restraint systems. Preliminary restraint concepts were developed and presented to long duration crewmembers and focus groups for feedback. Currently, a selection criterion is being refined for prioritizing the candidate concepts. Next steps include analytical and computer modeling evaluations of the selected candidate concepts, prototype development, and microgravity evaluations.

  20. Deaths due to physical restraint.

    Science.gov (United States)

    Berzlanovich, Andrea M; Schöpfer, Jutta; Keil, Wolfgang

    2012-01-01

    Physical restraint is used primarily for patients at risk of falling, those with motor unrest and agitated behavior, and those who manifest an intention of doing harm to themselves or are at risk of suicide. The use of freedom-restraining measures (FRM), and, in particular, the use of physical restraints against the patient's will, can be a serious intrusion of basic human rights and, as such, an act of violence against the patient. The improper use of physical restraints can cause injuries of varying severity, which can sometimes be fatal. We analyzed all cases of death under physical restraint that were recorded in the autopsy reports of the Institute of Forensic Medicine in Munich from 1997 to 2010. Among the 27 353 autopsies conducted over the period of the study, there were 26 cases of death while the individual was physically restrained. Three of these cases involved patients who died of natural causes while restrained, and one was a suicide. The remaining 22 deaths were caused solely by physical restraint; all of them occurred in patients under nursing care who were not continuously observed. The immediate cause of death was strangulation (11 cases), chest compression (8 cases), or dangling in the head-down position (3 cases). In 19 of these 22 patients, the restraints were incorrectly fastened, including two cases in which improvised non-standard restraints were used. One nursing-home patient died because of an abdominal restraint even though it had been correctly applied: She was mobile enough to slip through the restraint till it compressed her neck, and then unable to extricate herself from it, so that she died of strangulation. To prevent such deaths, we recommend from a forensic medical standpoint that all possible alternatives to FRM should be used instead. If direct-contact restraints are truly necessary, they must be applied as recommended and the restrained person must be closely observed.

  1. Effects of Quality Improvement System for Child Care Centers

    Science.gov (United States)

    Ma, Xin; Shen, Jianping; Kavanaugh, Amy; Lu, Xuejin; Brandi, Karen; Goodman, Jeff; Till, Lance; Watson, Grace

    2011-01-01

    Using multiple years of data collected from about 100 child care centers in Palm Beach County, Florida, the authors studied whether the Quality Improvement System (QIS) made a significant impact on quality of child care centers. Based on a pre- and postresearch design spanning a period of 13 months, QIS appeared to be effective in improving…

  2. Child Language Data Exchange System Tools for Clinical Analysis.

    Science.gov (United States)

    MacWhinney, Brian; Fromm, Davida

    2016-05-01

    The Child Language Data Exchange System Project has developed methods for analyzing many aspects of child language development, including grammar, lexicon, discourse, gesture, phonology, and fluency. This article will describe the methods available for each of these six fields, and how they can be used for assessment in the clinical setting.

  3. Implementing an Inpatient Social Early Warning System for Child Maltreatment

    Science.gov (United States)

    Atabaki, Armita; Heddaeus, Daniela; Metzner, Franka; Schulz, Holger; Siefert, Sonke; Pawils, Silke

    2013-01-01

    Objectives: The current article describes the process evaluation of a social early warning system (SEWS) for the prevention of child maltreatment in the federal state of Hamburg. This prevention initiative targets expectant mothers and their partners including an initial screening of risk factors for child maltreatment, a subsequent structured…

  4. Deaths due to physical restraint

    National Research Council Canada - National Science Library

    Berzlanovich, Andrea M; Schöpfer, Jutta; Keil, Wolfgang

    2012-01-01

    Physical restraint is used primarily for patients at risk of falling, those with motor unrest and agitated behavior, and those who manifest an intention of doing harm to themselves or are at risk of suicide...

  5. Optimal design of a seat belt restraint system based on approximate model management%基于近似模型管理的汽车安全带约束系统优化设计

    Institute of Scientific and Technical Information of China (English)

    刘鑫; 吴钢; 尹来荣

    2016-01-01

    In order to improve the protection capability of seat belt restraint systems,a numerical model of seat belt restraint systems was calibrated by vehicle crash experiments and an approximation model was constructed according to the radial basis function.The IP-GA genetic algorithm was employed to optimize the key parameters of the seat belt restraint system dynamic characteristics.To reduce the error from the approximate model,the management framework was used to update the approximate model and control the error in the optimization process.The optimal solutions with errors in given range can be treated as solutions to the problem.It was demonstrated that the proposed method could effectively find the optimal parameters of seat belt restraint systems and ensure their safety.%为提高汽车安全带约束系统的安全防护能力,通过实车碰撞实验对安全带约束系统数值模型进行校正;基于径向基函数建立安全带约束系统的近似模型,运用 IP -GA 遗传算法对安全带约束系统的动态特性参数进行优化。优化中为控制由近似模型所致误差,通过模型管理更新近似模型,并将误差达到允许范围内优化解作为实际问题的解。结果表明,该方法能快速有效获得安全带约束系统的最佳匹配参数,确保汽车乘员的安全性。

  6. Wheelchair integrated occupant restraints: feasibility in frontal impact.

    Science.gov (United States)

    VanRoosmalen, L; Bertocci, G E; Ha, D; Karg, P

    2001-12-01

    Individuals often use their wheelchair as a motor vehicle seat when traveling in motor vehicles. The current use of fixed vehicle-mounted wheelchair occupant restraint systems (FWORSs) often results in poor belt fit and discomfort. Additionally, satisfaction, usability and usage rate of FWORSs during transit use are often low. The automotive industry has shown improved occupant restraint usage, belt fit and injury protection when integrating the upper torso and pelvic restraint in a motor vehicle seat. This study compared occupant injury measures of a FWORS to a concept wheelchair integrated restraint system (WIRS) using a 20g frontal sled impact test with a 30 mph change in velocity. Neck loads, neck moments, head, pelvis and chest acceleration, sternum compression and knee and head excursion data were recorded from the wheelchair seated 50th percentile male hybrid III anthropomorphic test dummy (ATD). The WIRS resulted in a lower head injury criteria (HIC) value, lower sternum compression and a lower upper-torso restraint load than the FWORS. Compared with the FWORS, increased head, knee and wheelchair excursions and higher neck loads and moments were measured in the WIRS test. Both restraint scenario injury parameters were complied with occupant injury criteria based on General Motors Injury Assessment Reference Values (GM-IARVs) and occupant kinematic requirements defined by the Society of Automotive Engineers (SAE) voluntary standard, J2249. A higher motion criteria index was calculated for the WIRS scenario and a comparable combined injury criteria index was calculated for both restraint scenarios. The sled impact test showed WIRS concept feasibility, facilitating further development by industrial manufacturers who might further want to pursue this restraint principle to increase wheelchair occupant safety and comfort during transport in motor vehicles.

  7. Waldorf Schools: A Child-Centered System.

    Science.gov (United States)

    Ogletree, Earl J.

    This paper presents an overview of the philosophy, psychology of learning, teaching methods, and curriculum of the Waldorf Schools. Most Waldorf teachers are influenced by the esoteric form of critical idealism propounded by Rudolf Steiner. The child is considered by Steiner to be a spiritual being who has reincarnated on to earth in a physical…

  8. Betaine attenuates memory impairment after water-immersion restraint stress and is regulated by the GABAergic neuronal system in the hippocampus.

    Science.gov (United States)

    Kunisawa, Kazuo; Kido, Kiwamu; Nakashima, Natsuki; Matsukura, Takuya; Nabeshima, Toshitaka; Hiramatsu, Masayuki

    2017-02-05

    GABA mediated neuronal system regulates hippocampus-dependent memory and stress responses by controlling plasticity and neuronal excitability. Here, we demonstrate that betaine ameliorates water-immersion restraint stress (WIRS)-induced memory impairments. This improvement was inhibited by a betaine/GABA transporter-1 (GABA transporter-2: GAT2) inhibitor, NNC 05-2090. In this study, we investigated whether memory amelioration by betaine was mediated by the GABAergic neuronal system. Adult male mice were co-administered betaine and GABA receptor antagonists after WIRS. We also examined whether memory impairment after WIRS was attenuated by GABA receptor agonists. The memory functions were evaluated using a novel object recognition test 3-6 days after WIRS and/or the step-down type passive avoidance test at 7-8 days. The co-administration of the GABAA receptor antagonist bicuculline (1mg/kg) or the GABAB receptor antagonist phaclofen (10mg/kg) 1h after WIRS suppressed the memory-improving effects induced by betaine. Additionally, the administration of the GABAA receptor agonist muscimol (1mg/kg) or the GABAB receptor agonist baclofen (10mg/kg) 1h after WIRS attenuated memory impairments. These results were similar to the data observed with betaine. The treatment with betaine after WIRS significantly decreased the expression of GABA transaminase, and this effect was partially blocked by NNC 05-2090 in the hippocampus. WIRS caused a transient increase in hippocampal GABA levels and the changes after WIRS were not affected by betaine treatment in an in vivo microdialysis study. These results suggest that the beneficial effects of betaine may be mediated in part by changing the GABAergic neuronal system. Copyright © 2016 Elsevier B.V. All rights reserved.

  9. Developing a Child Friendly Text-to-Speech System

    Directory of Open Access Journals (Sweden)

    Agnes Jacob

    2008-01-01

    Full Text Available This paper discusses the implementation details of a child friendly, good quality, English text-to-speech (TTS system that is phoneme-based, concatenative, easy to set up and use with little memory. Direct waveform concatenation and linear prediction coding (LPC are used. Most existing TTS systems are unit-selection based, which use standard speech databases available in neutral adult voices. Here reduced memory is achieved by the concatenation of phonemes and by replacing phonetic wave files with their LPC coefficients. Linguistic analysis was used to reduce the algorithmic complexity instead of signal processing techniques. Sufficient degree of customization and generalization catering to the needs of the child user had been included through the provision for vocabulary and voice selection to suit the requisites of the child. Prosody had also been incorporated. This inexpensive TTS system was implemented in MATLAB, with the synthesis presented by means of a graphical user interface (GUI, thus making it child friendly. This can be used not only as an interesting language learning aid for the normal child but it also serves as a speech aid to the vocally disabled child. The quality of the synthesized speech was evaluated using the mean opinion score (MOS.

  10. Chronic restraint stress in rats causes sustained increase in urinary corticosterone excretion without affecting cerebral or systemic oxidatively generated DNA/RNA damage

    DEFF Research Database (Denmark)

    Jorgensen, Anders; Maigaard, Katrine; Wörtwein, Gitta

    2013-01-01

    and Tnf). The metabolism cage housing in itself did not significantly influence a range of biological stress markers. In the restraint stress group, there was a sustained 2.5 fold increase in 24h corticosterone excretion from day 2 after stress initiation. However, neither whole-body nor cerebral measures...

  11. Price Elasticity of Demand and Capacity-Restraint Transit Fare Strategy: A Case Study of Bangkok Mass Transit System

    Directory of Open Access Journals (Sweden)

    Ackchai Sirikijpanichkul

    2015-01-01

    Full Text Available Traffic congestion is a chronic problem of Bangkok. Similar to other metropolises, the city perpetually seeks for alternatives to road travel. Mass rapid transit seems to be the only way out that is expected to mitigate traffic congestion in the city. However, without common fare system, travelers need to pay an initial entrance fee every time they enter each transit system. This excess cost tapers the demand and affects the efficient use of the system. This research investigates the influence of fare price on transit use which is measured by price elasticity of demand and proposes the optimum fare price if the common fare is used. The analysis is based on the findings from the stated preference survey techniques. Finally, the conclusion on fare level that encourage more patronage, maintain service quality and operator revenue is addressed.

  12. 检察机关办理自侦案件接受监督制约制度的完善%Improvement of the system that the prosecution transact self-detecting cases to accept the supervision and restraint

    Institute of Scientific and Technical Information of China (English)

    潘凌; 徐艳

    2009-01-01

    The prosecutions, as the legal supervision organs, in order to ensure the quality and results of self-detecting cases, are necessary to constantly improve the system of accepting supervision and restraint, and establish multi-level and multi-link in the supervision system.%检察机关作为法律监督机关,为确保自行侦查案件质量和办案效果,就必须不断完善接受监督制约制度,建立多层次多环节的监督体系.

  13. Principles and core functions of integrated child health information systems.

    Science.gov (United States)

    Hinman, Alan R; Atkinson, Delton; Diehn, Tonya Norvell; Eichwald, John; Heberer, Jennifer; Hoyle, Therese; King, Pam; Kossack, Robert E; Williams, Donna C; Zimmerman, Amy

    2004-11-01

    Infants undergo a series of preventive and therapeutic health interventions and activities. Typically, each activity includes collection and submission of data to a dedicated information system. Subsequently, health care providers, families, and health programs must query each information system to determine the child's status in a given area. Efforts are underway to integrate information in these separate information systems. This requires specifying the core functions that integrated information systems must perform.

  14. Physical restraint deaths in a 13-year national cohort of nursing home residents.

    Science.gov (United States)

    Bellenger, Emma; Ibrahim, Joseph Elias; Bugeja, Lyndal; Kennedy, Briohny

    2017-07-01

    this paper aims to investigate the nature and extent of physical restraint deaths reported to Coroners in Australia over a 13-year period. the study comprised a retrospective cohort study of residents dwelling in accredited nursing homes in Australia whose deaths were reported to the Coroners between 1 July 2000 and 30 June 2013 and was attributed to physical restraint. five deaths in nursing home residents due to physical restraint were reported in Australia over a 13-year period. The median age of residents was 83 years; all residents had impaired mobility and had restraints applied for falls prevention. Neck compression and entrapment by the restraints was the mechanism of harm in all cases, resulting in restraint asphyxia and mechanical asphyxia, respectively. this national study confirms that the use of physical restraint does cause fatalities, although rare. Further research is still needed to identify which alternatives strategies to restraint are most effective, and to examine the reporting system for physical restraint-related deaths.

  15. Automobile restraints for children: a review for clinicians.

    Science.gov (United States)

    Howard, Andrew W

    2002-10-01

    More Canadian children die of road traffic injuries than of any other cause. Nonuse and misuse of child restraints is common and leads to preventable severe injuries or deaths. This article, intended for clinicians interested in injury prevention counselling, advocacy, research, and treatment of child occupants in car crashes, reviews current knowledge about child safety seats and discusses controversies related to their use. Children should sit in the back seat of a vehicle and should be properly restrained in a current age- and size-appropriate device (rear-facing infant seat, child safety seat, booster seat, or lap and shoulder seat belt) that is properly adjusted. The centre rear seat is safer than side positions, but a lap belt alone should be avoided. The age at which children should start sitting in a forward-facing position is controversial. Children should be seated away from air bags. Resources to aid in patient counselling are described.

  16. Child protection systems within the Danish, Finnish and Norwegian welfare states - time for a child centric approach?,

    DEFF Research Database (Denmark)

    Pösö, Tarja; Skivenes, Marit; Hestbæk, Anne-Dorthe

    2014-01-01

    This article explores the relationship between the child protection systems and the Nordic welfare state in Denmark, Finland and Norway. Despite an ideological focus on prevention and provision of a fair amount of universal services and in-home child protection services for families and children...... protection and related services. Consequently, many principles of the present child protection systems are – and will remain – challenged by a child-centric orientation, in which valuing children's needs, rights and voice in situ are central....

  17. Progressive systemic sclerosis in a child

    Directory of Open Access Journals (Sweden)

    Arun K De

    2013-01-01

    Full Text Available Systemic sclerosis is a clinically heterogeneous systemic disease affecting the connective tissues of skin, walls of blood vessels and internal organs like lung, heart and kidneys. Systemic sclerosis is very unusual in pediatric population. Children represent fewer than 10% of all cases. We report a case of 11 years old girl of progressive systemic sclerosis presenting with features of cutaneous sclerosis, microstomia, mask-like facies, sclerodactyly, esophageal dysmotility, Raynaud′s phenomenon, arthralgia and pulmonary fibrosis.

  18. Ethical dilemmas in social work practice with disabled people: the use of physical restraint.

    Science.gov (United States)

    Wilkins, David

    2012-06-01

    This article discusses the use of restraint with disabled adults and children and uses a case study of one particular child to explore issues related to the use of restraint, including the consent of the person subjected to restraint, their human rights, and the balancing of these rights with the need to reduce the risk of harm. The case study involves a young woman who requested to be restrained in a particular way and the challenges this posed to the staff caring for her. The article concludes that in many complex situations there is no clearly right approach to take, and each situation involving restraint must be considered on an individual case-by-case basis.

  19. Strengthening Child Protection Systems for Unaccompanied Migrant Children in Mozambique

    DEFF Research Database (Denmark)

    Verdasco Martinez, Andrea

    This research sets out to understand the why, how and with whom of rural-urban internal migration of children to Ressano Garcia, a border town between Mozambique and South Africa. It addresses the overarching research question of how to strengthen child protection systems for unaccompanied migrant...

  20. Organizational Climate, Services, and Outcomes in Child Welfare Systems

    Science.gov (United States)

    Glisson, Charles; Green, Philip

    2011-01-01

    Objective: This study examines the association of organizational climate, casework services, and youth outcomes in child welfare systems. Building on preliminary findings linking organizational climate to youth outcomes over a 3-year follow-up period, the current study extends the follow-up period to 7 years and tests main, moderating and…

  1. Organizational Climate, Services, and Outcomes in Child Welfare Systems

    Science.gov (United States)

    Glisson, Charles; Green, Philip

    2011-01-01

    Objective: This study examines the association of organizational climate, casework services, and youth outcomes in child welfare systems. Building on preliminary findings linking organizational climate to youth outcomes over a 3-year follow-up period, the current study extends the follow-up period to 7 years and tests main, moderating and…

  2. Vermont STep Ahead Recognition System: QRS Profile. The Child Care Quality Rating System (QRS) Assessment

    Science.gov (United States)

    Child Trends, 2010

    2010-01-01

    This paper presents a profile of Vermont's STep Ahead Recognition System (STARS) prepared as part of the Child Care Quality Rating System (QRS) Assessment Study. The profile consists of several sections and their corresponding descriptions including: (1) Program Information; (2) Rating Details; (3) Quality Indicators for All Child Care Programs;…

  3. Utilização de assentos de segurança por crianças matriculadas em creches Utilización de asientos de seguridad por niños matriculados en guarderías Child safety restraint use among children attending day care centers

    Directory of Open Access Journals (Sweden)

    Sergio Ricardo Lopes de Oliveira

    2009-10-01

    asociados. MÉTODOS: Estudio transversal observacional, con muestreo estratificado, realizado en 15 guarderías de la ciudad de Maringá (Sur de Brasil, entre los meses de marzo y mayo de 2007. Cada guardería fue visitada en sólo un día lectivo. El resultado considerado fue la utilización de asiento de seguridad infantil por niños de hasta cuatro anos de edad. Carros (N=301 que transportaban niños menores de cuatro anos de edad fueron abordados y las informaciones fueron colectadas por medio de cuestionarios semi-estructurados. Las variables relacionadas a distribución de adultos y niños en los asientos del vehículo, situación de restricción de adultos pasajeros y niños y sexo del conductor fueron analizadas. Para análisis de los datos se aplicó la prueba exacta de Fisher, ji-cuadrado de Mantel-Haenszel y regresión logística. RESULTADOS: Entre los conductores abordados, 51,8% usaban cinturón de seguridad (60,4% de las mujeres, 44,9% de los hombres. Entre los niños, 36,1% usaban asientos de seguridad infantil, 45,4% eran transportadas sueltas, 16,0% estaban en las piernas de adultos, 2,7% usaban el cinturón de seguridad. Según la regresión logística, los factores que más influenciaron el uso de asientos de seguridad infantil fueron: edad del niño inferior a 15 meses (OR=3,76, uso de cinturón de seguridad por el conductor (OR= 2,45 y niños pertenecientes a los estratos sociocupacionales de mayor renta y escolaridad (OR=1,37. CONCLUSIONES: La utilización de asientos de seguridad infantil se mostró asociada a la edad del niño, uso de cinturón de seguridad por el conductor y estrato sociocupacional de la guardería. Frente al bajo índice de utilización, el uso de los asientos de seguridad infantil surge como desafío a la medicina preventiva en Brasil, exigiendo atención y actuación para su diseminación en la población.OBJECTIVE: To estimate the prevalence of child safety restraint use and factors associated. METHODS: Observational cross

  4. Tennessee Star-Quality Child Care Program: QRS Profile. The Child Care Quality Rating System (QRS) Assessment

    Science.gov (United States)

    Child Trends, 2010

    2010-01-01

    This paper presents a profile of Tennessee's Star-Quality Child Care Program prepared as part of the Child Care Quality Rating System (QRS) Assessment Study. The profile consists of several sections and their corresponding descriptions including: (1) Program Information; (2) Rating Details; (3) Quality Indicators for Center-Based Programs; (4)…

  5. Compendium of Quality Rating Systems and Evaluations: The Child Care Quality Rating System (QRS) Assessment

    Science.gov (United States)

    Tout, Kathryn; Starr, Rebecca; Soli, Margaret; Moodie, Shannon; Kirby, Gretchen; Boller, Kimberly

    2010-01-01

    Quality Rating Systems (QRS) are currently operating, under development, or being piloted in over 25 states or local areas. As the QRS model becomes integrated into the landscape of child care and education service delivery, policy, and the decisions parents make about child care across the United States, there is an increasing need for…

  6. Children with problematic sexualized behaviors in the child welfare system.

    Science.gov (United States)

    Baker, Amy J L; Gries, Len; Schneiderman, Mel; Parker, Rob; Archer, Marc; Friedrich, Bill

    2008-01-01

    This study assessed the utility of the Child Sexual Behavior Inventory (CSBI) in a child welfare sample. In this study, 97 children from ages 10 to 12 from either foster boarding homes or a residential treatment center participated. Researchers interviewed foster parents or primary therapists about children's sexual behavior, traumatic events, clinical symptoms, and their attitudes toward the child. Findings revealed that problematic sexualized behaviors were more prevalent in the residential treatment center (RTC) sample than they were in a normative sample. The pattern of associations between sexual behavior problems, traumatic events, and clinical syndromes in both the RTC and the foster boarding home (FBH) samples was similar to what has been found in samples in which biological custodial parents were the respondents. Analyses comparing youth who met the criterion for having problematic sexualized behaviors and youth who did not meet the criterion revealed that the two groups differed on clinical symptoms, prior traumatic events, and negative reports by caregivers. Results confirm the utility of the CSBI measure for this population and highlight several important clinical and programmatic concerns for addressing problematic sexual behavior in children in the child welfare system.

  7. Shortcomings of the Child Protection System in Romania

    Directory of Open Access Journals (Sweden)

    CRISTINA DÂMBOEANU

    2010-04-01

    Full Text Available This article aims to emphasize the main shortcomings characterizing the system for the protection of children's rights in Romania. In this respect, the article presents the results of a qualitative research project, based on interviews and focus-group discussions with specialists in the field of child protection. This research was carried out by the Institute of Sociology within the National Research, Development and Innovation Plan (PNII, the Ideas program.

  8. Strengthening Child Protection Systems for Unaccompanied Migrant Children in Mozambique

    DEFF Research Database (Denmark)

    Verdasco Martinez, Andrea

    This research sets out to understand the why, how and with whom of rural-urban internal migration of children to Ressano Garcia, a border town between Mozambique and South Africa. It addresses the overarching research question of how to strengthen child protection systems for unaccompanied migrant...... migration at all stages of their journey. It provides a set of specific policies to address the needs of unaccompanied migrant children in Mozambique....

  9. Changing the Definition of Education. On Kant's Educational Paradox between Freedom and Restraint

    Science.gov (United States)

    Schaffar, Birgit

    2014-01-01

    Ever since Kant asked: "How am I to develop the sense of freedom in spite of the restraint?" in his lecture on education, the tension between necessary educational influence and unacceptable restriction of the child's individual development and freedom has been considered an educational paradox. Many have suggested solutions to the…

  10. Changing the Definition of Education. On Kant's Educational Paradox between Freedom and Restraint

    Science.gov (United States)

    Schaffar, Birgit

    2014-01-01

    Ever since Kant asked: "How am I to develop the sense of freedom in spite of the restraint?" in his lecture on education, the tension between necessary educational influence and unacceptable restriction of the child's individual development and freedom has been considered an educational paradox. Many have suggested solutions to the…

  11. Systemic lupus erythematosus South African child a black

    African Journals Online (AJOL)

    1991-01-19

    Jan 19, 1991 ... The first black South African child with SLE is docu- mented. The patient was .... physical appearance that the child was black, blood group and. HLA antigens were ... diagnosis and initiation of steroid therapy. The black'child.

  12. The Structure Characteristics and Diagnostic Test of Supplemental Restraint System on BENZ Car%奔驰轿车辅助防护系统的结构特点与诊断测试

    Institute of Scientific and Technical Information of China (English)

    舒华; 董宏国; 张煜; 刘磊

    2001-01-01

    The supplemental restraint system on BENZ car is composed of safety air bag system and safety belt retractor system.This paper introduces the structure characteristics,working principle and control circuit and expounds the fault code reading and delating methods.%奔驰轿车装备的辅助防护系统由安全气囊系统和座椅安全带收紧系统2部分组成,介绍了其结构特点、工作原理及控制电路,阐述了读取与清除故障代码的诊断测试方法。

  13. Vender/Voucher Systems: A Parent Selected Child Care Subsidy Program That Works.

    Science.gov (United States)

    Freis, Ruth; Miller, Miriam

    The vendor/voucher, or purchase of service, system for child care delivery is discussed as a logical model for communities which are looking for a method of developing a new system or have outgrown their current program. Discussion initially focuses on the increasing need for child care, cost/benefit aspects of child care, the regulation of child…

  14. A Count for Quality: Child Care Center Directors on Rating and Improvement Systems

    Science.gov (United States)

    Schulman, Karen; Matthews, Hannah; Blank, Helen; Ewen, Danielle

    2012-01-01

    Quality Rating and Improvement Systems (QRIS)--a strategy to improve families' access to high-quality child care--assess the quality of child care programs, offer incentives and assistance to programs to improve their ratings, and give information to parents about the quality of child care. These systems are operating in a growing number of…

  15. The economic cost of using restraint and the value added by restraint reduction or elimination.

    Science.gov (United States)

    Lebel, Janice; Goldstein, Robert

    2005-09-01

    The purpose of this study was to calculate the economic cost of using restraint on one adolescent inpatient service and to examine the effect of an initiative to reduce or eliminate the use of restraint after it was implemented. A detailed process-task analysis of mechanical, physical, and medication-based restraint was conducted in accordance with state and federal restraint requirements. Facility restraint data were collected, verified, and analyzed. A model was developed to determine the cost and duration of an average episode for each type of restraint. Staff time allocated to restraint activities and medication costs were computed. Calculation of the cost of restraint was restricted to staff and medication costs. Aggregate costs of restraint use and staff-related costs for one full year before the restraint reduction initiative (FY 2000) and one full year after the initiative (FY 2003) were calculated. Outcome, discharge, and recidivism data were analyzed. A comparison of the FY 2000 data with the FY 2003 data showed that the adolescent inpatient service's aggregate use of restraint decreased from 3,991 episodes to 373 episodes (91 percent), which was associated with a reduction in the cost of restraint from $1,446,740 to $117,036 (a 92 percent reduction). In addition, sick time, staff turnover and replacement costs, workers' compensation, injuries to adolescents and staff, and recidivism decreased. Adolescent Global Assessment of Functioning scores at discharge significantly improved. Implementation of a restraint reduction initiative was associated with a reduction in the use of restraint, staff time devoted to restraint, and staff-related costs. This shift appears to have contributed to better outcomes for adolescents, fewer injuries to adolescents and staff, and lower staff turnover. The initiative may have enhanced adolescent treatment and work conditions for staff.

  16. Maternal restraint and external eating behaviour are associated with formula use or shorter breastfeeding duration.

    Science.gov (United States)

    Brown, A

    2014-05-01

    Maternal eating behaviour (e.g. restraint, disinhibition) has been associated with maternal child-feeding style (e.g. pressure to eat, restricting intake, monitoring) for children over the age of two years. In particular, mothers high in restraint are significantly more likely to restrict and monitor their child's intake of food. Research has not however examined the impact of maternal eating behaviour upon earlier infant feeding. A controlling maternal child-feeding style has been linked with shorter breastfeeding duration and earlier introduction of solid foods but the relationship between infant milk feeding and maternal eating behaviour has not been explored despite links between maternal weight, body image and breastfeeding duration. The aim of the current study was to explore associations between maternal restraint, emotional and external eating and breastfeeding initiation and duration. Seven hundred and fifty-six mothers with an infant aged 6-12months completed a copy of the Dutch Eating Behaviour Questionnaire and reported breastfeeding duration and formula use up to six months postpartum. Mothers high in restraint and external eating were significantly more likely to formula feed from birth, to breastfeed for a shorter duration and to introduce formula milk sooner than those lower in these behaviours. Moreover these behaviours were associated with reporting greater control during milk feeding by feeding to a mother-led rather than baby-led routine. Maternal eating behaviour may therefore affect breastfeeding initiation and continuation and is an important element for discussion for those working to support new mothers.

  17. Factors Associated with Service Use among Immigrants in the Child Welfare System

    Science.gov (United States)

    Rajendran, Khushmand; Chemtob, Claude M.

    2010-01-01

    This study investigated child, caregiver, and caseworker factors associated with greater use of family support services by immigrant families in the U.S. child welfare system. Among child factors, higher levels of internalizing behavior problems (Odds Ratio (O.R.) = 3.60), externalizing behavior problems (O.R. = 2.62) and a history of neglect…

  18. Multiple Response System: Evaluation of Policy Change in North Carolina's Child Welfare System.

    Science.gov (United States)

    Lawrence, C Nicole; Rosanbalm, Katie D; Dodge, Kenneth A

    2011-11-01

    Systemic challenges within child welfare have prompted many states to explore new strategies aimed at protecting children while meeting the needs of families, but doing so within the confines of shrinking budgets. Differential Response has emerged as a promising practice for low or moderate risk cases of child maltreatment. This mixed methods evaluation explored various aspects of North Carolina's differential response system, known as the Multiple Response System (MRS), including: child safety, timeliness of response and case decision, frontloading of services, case distribution, implementation of Child and Family Teams, collaboration with community-based service providers and Shared Parenting. Utilizing Child Protective Services (CPS) administrative data, researchers found that compared to matched control counties, MRS: had a positive impact on child safety evidenced by a decline in the rates of substantiations and re-assessments; temporarily disrupted timeliness of response in pilot counties but had no effect on time to case decision; and increased the number of upfront services provided to families during assessment. Qualitative data collected through focus groups with providers and phone interviews with families provided important information on key MRS strategies, highlighting aspects that families and social workers like as well as identifying areas for improvement. This information is useful for continuous quality improvement efforts, particularly related to the development of training and technical assistance programs at the state and local level.

  19. The reliability of child psychiatric diagnosis. A comparison among Danish child psychiatrists of traditional diagnoses and a multiaxial diagnostic system

    DEFF Research Database (Denmark)

    Skovgaard, A M; Isager, T; Jørgensen, O S

    1988-01-01

    diagnostic systems. Diagnostic reliability was measured as percentage of interrater agreement. The highest diagnostic reliability was obtained in psychotic disorders, the lowest in personality disorders. The MAS implied improved diagnostic reliability of mental retardation, somatic disorders......The study was conducted to compare an experimental multiaxial diagnostic system (MAS) with traditional multicategorical diagnoses in child psychiatric work. Sixteen written case histories were circulated to 21 child psychiatrists, who made diagnoses independently of one another, using two different...... and developmental disorders. Adjustment reaction (reactio maladaptiva) was the diagnosis most commonly used, but with varying reliability in both systems. The reliability of the socio-economic and psychosocial axes were generally high....

  20. North Carolina Star Rated License System: QRS Profile. The Child Care Quality Rating System (QRS) Assessment

    Science.gov (United States)

    Child Trends, 2010

    2010-01-01

    This paper presents a profile of North Carolina's Star Rated License System prepared as part of the Child Care Quality Rating System (QRS) Assessment Study. The profile consists of several sections and their corresponding descriptions including: (1) Program Information; (2) Rating Details; (3) Quality Indicators for Center-Based Programs; (4)…

  1. Further thoughts on the process of restraint.

    Science.gov (United States)

    Winship, G

    2006-02-01

    The physical restraint of a disturbed person is a subject constant of psychiatry and is a challenge that particularly faces nurses working in acute inpatient settings. While other approaches to psychiatric treatment have been discarded (e.g. punishment, blood letting, trepanation, deep insulin therapy and so on) or evolved into new treatments (the use of medication), the act of physical restraint has remained largely unmodified. Given the ubiquity of physical restraint in psychiatry, particularly as a nursing procedure, the absence of a sustained body of research is notable. This essay examines some of the historical underpinnings of the use of restraint in psychiatry brought into sharp focus by the David Bennett Inquiry Report (2003) and the National Institute of Clinical Effective (NICE) guidelines (2005) on the management of violence.

  2. The evolution of reproductive restraint through social communication.

    Science.gov (United States)

    Werfel, Justin; Bar-Yam, Yaneer

    2004-07-27

    The evolution of altruistic behavior through group selection is generally viewed as possible in theory but unlikely in reality, because individual selection favoring selfish strategies should act more rapidly than group selection favoring cooperation. Here we demonstrate the evolution of altruism, in the form of conditional reproductive restraint based on an explicitly social mechanism, modulated by intrapopulation communication comprising signal and evolved response, in a spatially distributed predatory/parasitic/pathogenic model system. The predatory species consistently comes to exploit a signal implying overcrowding, individuals constraining their reproduction in response, with a corresponding increase in equilibrium reproduction rate in the absence of signal. This signaled restraint arises in a robust way for a range of model spatial systems; it outcompetes non-signal-based restraint and is not vulnerable to subversion by noncooperating variants. In these systems, communication is used to evaluate population density and regulate reproduction accordingly, consistent with central ideas of Wynne-Edwards [Wynne-Edwards, V. C. (1962) Animal Dispersion in Relation to Social Behavior (Hafner, New York)], whose claims about the evolutionary importance of group selection helped ignite decades of controversy. This quantitative simulation model shows how the key evolutionary transition from solitary living to sociality can occur. The process described here of cooperation evolving through communication may also help to explain other major evolutionary transitions such as intercellular communication leading to multicellular organisms.

  3. Systemic phaeohyphomycosis due to Exophiala (Wangiella) in an immunocompetent child.

    Science.gov (United States)

    Alabaz, Derya; Kibar, Filiz; Arikan, Sevtap; Sancak, Banu; Celik, Umit; Aksaray, Necmi; Turgut, Mehmet

    2009-01-01

    We report a rare case of systemic lymphadenitis and hepatic involvement due to Exophiala (Wangiella) dermatitidis in a pediatric patient. An 8-year-old immunocompetent boy with chronic fever was examined through the use of sonography and CT scan which demonstrated cervical and mesenteric lymph node enlargement and numerous small hepatic lesions. The etiologic agent was isolated by means of lymph node aspiration. The fungus was identified by its morphological characteristics and through DNA sequencing of the internal transcribed spacer region of rDNA. Despite initial amphotericin B and voriconazole therapy, the child's jaundice subsided and he died 7 months later. In addition to pathogenic aspects of Exophiala dermatitidis, the diagnostic approaches and relevant therapeutic strategies are discussed.

  4. Differentiating between child protection and family support in the Canadian child welfare system's response to intimate partner violence, corporal punishment, and child neglect.

    Science.gov (United States)

    Trocmé, Nico; Fallon, Barbara; Sinha, Vandna; Van Wert, Melissa; Kozlowski, Anna; Maclaurin, Bruce

    2013-01-01

    Rates of reported child maltreatment nearly doubled in Canada over the period 1998-2003, an increase that reflects growing awareness of the harmful effects of an expanding array of parental behaviors, including corporal punishment, lack of supervision, and exposure to intimate partner violence (IPV). Some of these situations may benefit from voluntary family support programs outside of the child welfare system. Analyzing a sample of 11,807 investigations, this paper compares cases where the sole concern is exposure to IPV, or hitting a child, or neglect, or other forms of investigated maltreatment. Situations where exposure to IPV or potentially abusive hitting were the sole reason for investigation presented with fewer risk factors and were less likely to lead to ongoing child welfare interventions compared to other maltreatment investigations. While situations involving alleged neglect presented a higher risk profile and elicited a more intensive child welfare response than did exposure to IPV or hitting, opportunities for alternative services were nevertheless identified. The study also found that visible minority families were overrepresented in cases involving hitting and that Aboriginal families were overrepresented in cases involving neglect. Overall the findings support the development of alternative response programs in Canada.

  5. Forensic, cultural, and systems issues in child sexual abuse cases--part 1: an introduction.

    Science.gov (United States)

    Tishelman, Amy C; Geffner, Robert

    2010-09-01

    This article introduces the first in a two-part special issue focusing on forensic, cultural, and systems issues in child sexual abuse cases. The five articles contained in this issue include a diversity of perspectives on approaches to extended interviews and evaluations of child sexual abuse suspicions, an exploration of the ways culture affects child sexual abuse disclosure and reporting, considerations relevant to the management of a child's mental health needs while forensic process are ongoing, and the use of anatomical dolls in forensic interviews. We call for attention to several practice areas, including (a) prioritizing a child's mental health needs while minimizing disruption of forensic processes, (b) developing best practices and models of child sexual abuse assessment and evaluation when a one-session forensic interview is insufficient, (c) appropriately evaluating child sexual abuse concerns when they occur without a disclosure and/or in children with communication limitations, and (d) the integration of cultural sensitivity into interviews and evaluations.

  6. Application of Knowledge Based Systems for Child Performance Analysis in an Online Montessori Management System

    Directory of Open Access Journals (Sweden)

    Siti Hajar Khairuddin

    2012-01-01

    Full Text Available This paper focuses on the application of knowledge based systems for child performance analysis in an online Montessori module. Using knowledge based techniques, the system generates an automatic analysis based on the teacher's answers to a variety of questions about a child's performance of a specific Montessori activity. The questions were created through a study of the criteria used to assess the level of a child's performance and achievement. This prototype is designed as a proof-of-concept, to show how the knowledge base technique could be applied. To design the prototype, we conducted literature reviews on the delivery of Montessori methods and the knowledge base technique, and compared rule -based and case -based reasoning.  We selected rule-based reasoning for the concept prototype since it is suitable for Montessori activities which are well defined and easy to acquire.

  7. Integrating child health information systems in public health agencies.

    Science.gov (United States)

    Bara, Debra; McPhillips-Tangum, Carol; Wild, Ellen L; Mann, Marie Y

    2009-01-01

    Public health agencies at state and local levels are integrating information systems to improve health outcomes for children. An assessment was conducted to describe the extent to which public health agencies are currently integrating child health information systems (CHIS). Using online technology information was collected, to assess completed and planned activities related to integration of CHIS, maturity of these systems, and factors that influence decisions by public health agencies to pursue integration activities. Of the 39 public health agencies that participated, 18 (46%) reported already integrating some or all of their CHIS, and 13 (33%) reported to be planning to integrate during the next 3 years. Information systems most commonly integrated include Early Hearing Detection and Intervention (EHDI), immunization, vital records, and Newborn Dried Bloodspot Screening (NDBS). Given the high priority that has been placed on using technology to improve health status in the United States, the emphasis on expanding the capability for the electronic exchange of health information, and federal support for electronic health records by 2014, public health agencies should be encouraged and supported in their efforts to develop, implement, and maintain integrated CHIS to facilitate the electronic exchange of health information with the clinical healthcare sector.

  8. International Space Station Crew Restraint Design

    Science.gov (United States)

    Whitmore, M.; Norris, L.; Holden, K.

    2005-01-01

    With permanent human presence onboard the International Space Station (ISS), crews will be living and working in microgravity, dealing with the challenges of a weightless environment. In addition, the confined nature of the spacecraft environment results in ergonomic challenges such as limited visibility and access to the activity areas, as well as prolonged periods of unnatural postures. Without optimum restraints, crewmembers may be handicapped for performing some of the on-orbit tasks. Currently, many of the tasks on ISS are performed with the crew restrained merely by hooking their arms or toes around handrails to steady themselves. This is adequate for some tasks, but not all. There have been some reports of discomfort/calluses on the top of the toes. In addition, this type of restraint is simply insufficient for tasks that require a large degree of stability. Glovebox design is a good example of a confined workstation concept requiring stability for successful use. They are widely used in industry, university, and government laboratories, as well as in the space environment, and are known to cause postural limitations and visual restrictions. Although there are numerous guidelines pertaining to ventilation, seals, and glove attachment, most of the data have been gathered in a 1-g environment, or are from studies that were conducted prior to the early 1980 s. Little is known about how best to restrain a crewmember using a glovebox in microgravity. In 2004, The Usability Testing and Analysis Facility (UTAF) at the NASA Johnson Space Center completed development/evaluation of several design concepts for crew restraints to meet the various needs outlined above. Restraints were designed for general purpose use, for teleoperation (Robonaut) and for use with the Life Sciences Glovebox. All design efforts followed a human factors engineering design lifecycle, beginning with identification of requirements followed by an iterative prototype/test cycle. Anthropometric

  9. Resources within "Reason": Resources for Supporting Young Children in the Child Welfare System

    Science.gov (United States)

    Dinehart, Laura H.; Catlett, Camille

    2011-01-01

    For teachers, working with young children in the child welfare system can be challenging. A high-quality early learning environment has been linked to long-term positive developmental and academic success. But for children in the child welfare system who are facing significant early challenges, a high quality environment can provide the…

  10. Resources within "Reason": Resources for Supporting Young Children in the Child Welfare System

    Science.gov (United States)

    Dinehart, Laura H.; Catlett, Camille

    2011-01-01

    For teachers, working with young children in the child welfare system can be challenging. A high-quality early learning environment has been linked to long-term positive developmental and academic success. But for children in the child welfare system who are facing significant early challenges, a high quality environment can provide the…

  11. Development of the System on the Internet for Pre-Assessment of Child Abuse Prevention

    Science.gov (United States)

    Honma, Satoru; Wakamatsu, Hidetoshi; Ueda, Reiko

    Some assessments have been applied to find possible factors that might lead to child abuse. PACAP is a new method proposed by Ueda and others as a pre-assessment of the concerning child abuse, which reduces its false-positive misclassification. The Internet PACAP is developed to reduce the laborious work of nurses and health care workers for the necessary processing and classifying the scores of the pre-assessment. The present system is expected to prevent the child abuse more effectively.

  12. Addressing substance abuse treatment needs of parents involved with the child welfare system.

    Science.gov (United States)

    Oliveros, Arazais; Kaufman, Joan

    2011-01-01

    The goal of this paper is to synthesize available data to help guide policy and programmatic initiatives for families with substance abuse problems who are involved with the child welfare system, and identify gaps in the research base preventing further refinement of practices in this area. To date, Family Treatment Drug Court and newly developed home-based substance abuse treatment interventions appear the most effective at improving substance abuse treatment initiation and completion in child welfare populations. Research is needed to compare the efficacy of these two approaches, and examine cost and child well-being indicators in addition to substance abuse treatment and child welfare outcomes.

  13. The Therapy Process Observational Coding System for Child Psychotherapy Strategies Scale

    Science.gov (United States)

    McLeod, Bryce D.; Weisz, John R.

    2010-01-01

    Most everyday child and adolescent psychotherapy does not follow manuals that document the procedures. Consequently, usual clinical care has remained poorly understood and rarely studied. The Therapy Process Observational Coding System for Child Psychotherapy-Strategies scale (TPOCS-S) is an observational measure of youth psychotherapy procedures…

  14. Collaborative Efforts to Improve System Response to Families Who Are Experiencing Child Maltreatment and Domestic Violence

    Science.gov (United States)

    Banks, Duren; Dutch, Nicole; Wang, Kathleen

    2008-01-01

    The "Greenbook" demonstration initiative provided federal funding and other support to six communities to establish collaborations to plan and implement policy and practice changes in systems that serve families who are experiencing domestic violence and child maltreatment or child exposure to domestic violence. The demonstration sites established…

  15. 76 FR 560 - Office of Child Support Enforcement Privacy Act of 1974; System of Records

    Science.gov (United States)

    2011-01-05

    ... HUMAN SERVICES Administration for Children and Families Office of Child Support Enforcement Privacy Act... requirements of the Privacy Act of 1974 (5 U.S.C. 552a), as amended, the Office of Child Support Enforcement (OCSE) is publishing notice that it will rescind a notice of a system of records entitled ``Location...

  16. Navigating the Child Support System: Lessons from the Fathers at Work Initiative

    Science.gov (United States)

    Wyckoff, Laura; McVay, Mary; Wallace, Dee

    2009-01-01

    Research shows that nearly half of all children born in the US today will be eligible for child support before they reach the age of 18. Many low-income, noncustodial fathers--who often struggle to make these payments--will seek services from workforce development organizations. Yet, understanding the child support enforcement system can be…

  17. Psychotropic Medication Use among Children in the Child Welfare System. Issue Brief No. 59, Fall 2012

    Science.gov (United States)

    Walsh, Wendy A.; Mattingly, Marybeth J.

    2012-01-01

    Prior research demonstrates that children in the child welfare system are given psychotropic medication at rates approximately three times higher than children and adolescents in the general population. Using data from the second National Survey of Child and Adolescent Well-Being, authors Wendy Walsh and Marybeth Mattingly report that among…

  18. Occupant restraint in the rear seat: ATD responses to standard and pre-tensioning, force-limiting belt restraints.

    Science.gov (United States)

    Forman, Jason; Michaelson, Jarett; Kent, Richard; Kuppa, Shashi; Bostrom, Ola

    2008-10-01

    Recent studies have shown that restrained occupants over the age of 50 in frontal crashes have a higher risk of injury in the rear seat than in the front, and have hypothesized that the incorporation of technology such as belt pre-tensioning and force limiting preferentially in the front seat is at least partially responsible for this trend. This study investigates the potential benefits and trade-offs of seat belt pretensioners and force-limiters in the rear seat using a series of frontal impact sled tests at two speeds (48 km/h and 29 km/h DeltaV) with a buck representing the interior of the reat seat occupant compartment of a contemporary mid-sized sedan. Four different dummies were tested: the Hybrid III six year old (in a booster seat, H3 6YO), the Hybrid III 5(th) percentile female (H3 AF05), the Hybrid III 50(th) percentile male (H3 AM50), and the THOR-NT. The restraints consisted of either a standard three point belt, or a 3-point belt with a retractor pretensioner and a progressive force-limiter (FL+PT). Each test condition was repeated in triplicate. The FL+PT restraints (compared to the standard restraints) resulted in a significant (p < or = 0.05) decrease in peak internal chest deflection for each of the Hybrid III dummies at both test speeds (48 km/h: 29% decrease for H3 6YO, 38% decrease for H3 AF05, 30% decrease for H3 AM50), and for the THOR-NT at a DeltaV of 29 km/h. At 48 km/h, the FL+PT restraint qualitatively decreased the average peak internal chest deflection of the THOR-NT, however this decrease was not statistically significant (p=0.06). Furthermore, the FL+PT system allowed little or no increase in forward head excursion, and improved whole-body kinematics for all dummies by restricting pelvic excursion and slightly increasing torso pitch. The results suggest that the FL+PT system studied here may provide injury-reducing benefit to rear seat occupants in moderate to high severity frontal crashes, although more study is needed to evaluate

  19. Occupant Restraint in the Rear Seat: ATD Responses to Standard and Pre-tensioning, Force-Limiting Belt Restraints

    Science.gov (United States)

    Forman, Jason; Michaelson, Jarett; Kent, Richard; Kuppa, Shashi; Bostrom, Ola

    2008-01-01

    Recent studies have shown that restrained occupants over the age of 50 in frontal crashes have a higher risk of injury in the rear seat than in the front, and have hypothesized that the incorporation of technology such as belt pre-tensioning and force limiting preferentially in the front seat is at least partially responsible for this trend. This study investigates the potential benefits and trade-offs of seat belt pretensioners and force-limiters in the rear seat using a series of frontal impact sled tests at two speeds (48 km/h and 29 km/h ΔV) with a buck representing the interior of the reat seat occupant compartment of a contemporary mid-sized sedan. Four different dummies were tested: the Hybrid III six year old (in a booster seat, H3 6YO), the Hybrid III 5th percentile female (H3 AF05), the Hybrid III 50th percentile male (H3 AM50), and the THOR-NT. The restraints consisted of either a standard three point belt, or a 3-point belt with a retractor pretensioner and a progressive force-limiter (FL+PT). Each test condition was repeated in triplicate. The FL+PT restraints (compared to the standard restraints) resulted in a significant (p≤0.05) decrease in peak internal chest deflection for each of the Hybrid III dummies at both test speeds (48 km/h: 29% decrease for H3 6YO, 38% decrease for H3 AF05, 30% decrease for H3 AM50), and for the THOR-NT at a ΔV of 29 km/h. At 48 km/h, the FL+PT restraint qualitatively decreased the average peak internal chest deflection of the THOR-NT, however this decrease was not statistically significant (p=0.06). Furthermore, the FL+PT system allowed little or no increase in forward head excursion, and improved whole-body kinematics for all dummies by restricting pelvic excursion and slightly increasing torso pitch. The results suggest that the FL+PT system studied here may provide injury-reducing benefit to rear seat occupants in moderate to high severity frontal crashes, although more study is needed to evaluate these restraints

  20. Behavioral Intervention to Reduce Child and Parent Distress during Venipuncture.

    Science.gov (United States)

    Manne, Sharon L.; And Others

    1990-01-01

    Investigated behavioral intervention to control child distress during invasive cancer treatment. Children (n=23) requiring physical restraint to complete venipuncture were alternately assigned to behavioral intervention or attention control condition. Observed child distress, parent-rated child distress, and parent ratings of own distress were…

  1. Physical Restraint Initiation in Nursing Homes and Subsequent Resident Health

    Science.gov (United States)

    Engberg, John; Castle, Nicholas G.; McCaffrey, Daniel

    2008-01-01

    Purpose: It is widely believed that physical restraint use causes mental and physical health decline in nursing home residents. Yet few studies exist showing an association between restraint initiation and health decline. In this research, we examined whether physical restraint initiation is associated with subsequent lower physical or mental…

  2. Freedom from restraint: consequences of reducing physical restraints in the management of the elderly.

    Science.gov (United States)

    Powell, C; Mitchell-Pedersen, L; Fingerote, E; Edmund, L

    1989-01-01

    Physical restraint is commonly used in the management of elderly people in North American hospitals and nursing homes. Between December 1981 and March 1982 the Department of Geriatric Medicine, St. Boniface General Hospital, Winnipeg, changed its practice regarding the use of such restraints. In the fiscal year 1980-81 the rate of application of physical restraints was 52 per 1000 patient-days and the frequency of falls 7 per 1000 patient-days. By 1986-87 the figures were 0.3 and 8.7 per 1000 patient-days respectively; the increase in falls was not clinically significant. During the study period there was a 40% reduction in the use of chemical restraints (psychotropic drugs other than hypnotic and antidepressant agents). Here we record how this change in practice occurred and persisted. PMID:2776096

  3. On Restraint of and Supervision over Power

    Institute of Scientific and Technical Information of China (English)

    DONG YUNHU

    2007-01-01

    @@ Power is the nucleus of social and political life. Effective restraint on and supervision over the operation of power is the fundamental way of preventing corruption of power, which at the same time constitutes an important indication to democracy and its development in a given country.

  4. PDBStat: a universal restraint converter and restraint analysis software package for protein NMR

    Energy Technology Data Exchange (ETDEWEB)

    Tejero, Roberto [Rutgers, The State University of New Jersey, Center for Advanced Biotechnology and Medicine (United States); Snyder, David [William Paterson University, Department of Chemistry (United States); Mao, Binchen; Aramini, James M.; Montelione, Gaetano T., E-mail: guy@cabm.rutgers.edu [Rutgers, The State University of New Jersey, Center for Advanced Biotechnology and Medicine (United States)

    2013-08-15

    The heterogeneous array of software tools used in the process of protein NMR structure determination presents organizational challenges in the structure determination and validation processes, and creates a learning curve that limits the broader use of protein NMR in biology. These challenges, including accurate use of data in different data formats required by software carrying out similar tasks, continue to confound the efforts of novices and experts alike. These important issues need to be addressed robustly in order to standardize protein NMR structure determination and validation. PDBStat is a C/C++ computer program originally developed as a universal coordinate and protein NMR restraint converter. Its primary function is to provide a user-friendly tool for interconverting between protein coordinate and protein NMR restraint data formats. It also provides an integrated set of computational methods for protein NMR restraint analysis and structure quality assessment, relabeling of prochiral atoms with correct IUPAC names, as well as multiple methods for analysis of the consistency of atomic positions indicated by their convergence across a protein NMR ensemble. In this paper we provide a detailed description of the PDBStat software, and highlight some of its valuable computational capabilities. As an example, we demonstrate the use of the PDBStat restraint converter for restrained CS-Rosetta structure generation calculations, and compare the resulting protein NMR structure models with those generated from the same NMR restraint data using more traditional structure determination methods. These results demonstrate the value of a universal restraint converter in allowing the use of multiple structure generation methods with the same restraint data for consensus analysis of protein NMR structures and the underlying restraint data.

  5. Implementation Of Law Number 11 Of 2012 Concerning Child Related Criminal Justice System Concept Restorative Justice

    National Research Council Canada - National Science Library

    Intan Karangan

    2016-01-01

    ... No. 11 of 2012 on Child Criminal Justice system. This study uses normative namely a study that discusses the problem based on the literature and legislation relating to the matter to be investigated. Law...

  6. Physical Restraint in Critical Care Settings: Will They Go Away?

    Science.gov (United States)

    Mion, Lorraine C.

    2015-01-01

    The critical care setting is perhaps the last major health care setting in which physical restraint remains a common, and oftentimes unquestioned, practice. This is despite the numerous regulations and accrediting standards that have limited or even eliminated practitioners’ use of physical restraints in other health care settings. The decision to use physical restraint in the care of critically ill patients can be complex and is influenced by characteristics of the patient, the practitioner, and the environment. What do we know about physical restraint practice in critical care settings, and what steps must we take if we are, indeed, to become “restraint-free” environments? PMID:19064141

  7. Reenactment of circumstances in deaths related to restraint.

    Science.gov (United States)

    O'Halloran, Ronald L

    2004-09-01

    Reenactment of the circumstances in deaths associated with restraint, utilizing participants and witnesses while memories are fresh, may help death investigators more accurately determine the cause of death. Two recent deaths in Ventura County that occurred during restraint are discussed. Within a day of the autopsies the restrainers agreed to participate in reenactments of the restraint process, utilizing live volunteers as subjects. They allowed videotaping. Deaths associated with restraint often have nonspecific autopsy findings. Timely reenactment of the circumstances of deaths associated with restraint can help death investigators more accurately determine the probable cause of death in these difficult cases.

  8. Ligamentous and capsular restraints to experimental posterior elbow joint dislocation

    DEFF Research Database (Denmark)

    Deutch, Søren R; Olsen, Bo S; Jensen, Steen L

    2003-01-01

    Pathological external forearm rotation (PEFR) relates to posterolateral elbow joint instability, and is considered a possible requisite step in a simple posterior elbow joint dislocation. The aim of this study was to evaluate the capsuloligamentous restraint to PEFR. In all, 18 elbow joint...... specimens were examined in a joint analysis system developed for experimental elbow dislocation. Sequential cutting of capsule and ligaments followed by stability testing provided specific data relating to each capsuloligamentous structure. The primary stabilizers against PEFR in the extended elbow were...

  9. Mobilizing social capital to deal with child labour in cocoa production: The case of community child labour monitoring system in Ghana

    NARCIS (Netherlands)

    Owusu-Amankwah, R.; Ruivenkamp, G.T.P.; Frempong, G.; Essegbey, G.

    2014-01-01

    The Government of Ghana is leading the implementation of Community Child Labour Monitoring (CCLM) System as remediation and monitoring tool to free cocoa production from the worst forms of child labour and trafficking. Through a mixed-method approach which combines exploratory qualitative and quanti

  10. Mobilizing social capital to deal with child labour in cocoa production: The case of community child labour monitoring system in Ghana

    NARCIS (Netherlands)

    Owusu-Amankwah, R.; Ruivenkamp, G.T.P.; Frempong, G.; Essegbey, G.

    2014-01-01

    The Government of Ghana is leading the implementation of Community Child Labour Monitoring (CCLM) System as remediation and monitoring tool to free cocoa production from the worst forms of child labour and trafficking. Through a mixed-method approach which combines exploratory qualitative and

  11. Aceh Free Pasung: Releasing the mentally ill from physical restraint.

    Science.gov (United States)

    Puteh, Ibrahim; Marthoenis, M; Minas, Harry

    2011-05-14

    Physical restraint and confinement of the mentally ill (called pasung in Indonesia) is common in Aceh. In early 2010, the local government initiated a program called Aceh Free Pasung 2010. The main goal of the program is to release the mentally ill in the province from restraint and to provide appropriate medical treatment and care. The aim of the paper is to report the findings of a preliminary investigation of the demographic and clinical characteristics of patients who have been admitted to the Banda Aceh Mental Hospital as part of the Aceh Free Pasung program. This is a cross-sectional descriptive study conducted at the Banda Aceh Mental Hospital, where people who had been restrained or confined in the community are being admitted for psychiatric treatment and, where necessary, physical rehabilitation, as part of the Aceh Free Pasung program. Fifty-nine of former ex-pasung patients were examined. The majority (88.1%) of the patients were male, aged 18 to 68 years. The duration of pasung varied from a few days to 20 years, with a mean duration of 4.0 years. The reasons for applying pasung are many, with concerns about dangerousness being most common. The great majority (89.8%) had a diagnosis of schizophrenia. The development of a community mental health system and the introduction of a health insurance system in Aceh (together with the national health insurance scheme for the poor) has enabled access to free hospital treatment for people with severe mental disorders, including those who have been in pasung. The demographic and clinical characteristics of this group of ex-pasung patients are broadly similar to those reported in previous studies. The Aceh Free Pasung program is an important mental health and human rights initiative that can serve to inform similar efforts in other parts of Indonesia and other low and middle-income countries where restraint and confinement of the mentally ill is receiving insufficient attention.

  12. Development of a Deflection Measurement System for the Hybrid III Six-Year Old Biofidelic Abdomen

    OpenAIRE

    2012-01-01

    Despite advancements in automotive safety, motor vehicle collisions remain the leading cause of unintentional death for children ages 5 to 14. Enhancement of child occupant protection depends on the ability to accurately assess the effectiveness of restraint systems. Booster seat design and proper belt fit require evaluation using child anthropomorphic test devices, yet biofidelity of the abdomen and pelvis of the current anthropomorphic test device, the Hybrid III 6-year-old, needs improveme...

  13. Physical restraint usage at a teaching hospital: a pilot study.

    Science.gov (United States)

    Barton-Gooden, Antoinette; Dawkins, Pauline E; Bennett, Joanna

    2015-02-01

    This mixed method study examines the prevalence of restraint usage; perception of nurses and doctors about the practice and whether they were trained to apply physical restraints. The physical restraint prevalence tools were used to observe 172 adult patients and conduct 47 chart audits in the medical-surgical wards and a psychiatric unit in November 2011. Focus group discussions with nurses and doctors were conducted. Quantitative data were analyzed using the SPSS and focus group discussions thematically analyzed. The prevalence of physical restraints between the medical-surgical wards was 75%. Nurses and medical doctors were not formally trained to apply restraint, and had learnt from peer observation. They expressed sadness, guilt, and fear when restraints are used and identified that inadequate institutional support existed. Restraint usage was high, and nurses and doctors experienced moral dilemma when they perceived that lack of formal training and inadequate institutional support may contribute to patient injury. © The Author(s) 2013.

  14. Impact of Child Maltreatment on Attachment and Social Rank Systems: Introducing an Integrated Theory.

    Science.gov (United States)

    Sloman, Leon; Taylor, Peter

    2016-04-01

    Child maltreatment is a prevalent societal problem that has been linked to a wide range of social, psychological, and emotional difficulties. Maltreatment impacts on two putative evolved psychobiological systems in particular, the attachment system and the social rank system. The maltreatment may disrupt the child's ability to form trusting and reassuring relationships and also creates a power imbalance where the child may feel powerless and ashamed. The aim of the current article is to outline an evolutionary theory for understanding the impact of child maltreatment, focusing on the interaction between the attachment and the social rank system. We provide a narrative review of the relevant literature relating to child maltreatment and these two theories. This research highlights how, in instances of maltreatment, these ordinarily adaptive systems may become maladaptive and contribute to psychopathology. We identify a number of novel hypotheses that can be drawn from this theory, providing a guide for future research. We finally explore how this theory provides a guide for the treatment of victims of child maltreatment. In conclusion, the integrated theory provides a framework for understanding and predicting the consequences of maltreatment, but further research is required to test several hypotheses made by this theory.

  15. Real-world adjustments of driver seat and head restraint in Saab 9-3 vehicles.

    Science.gov (United States)

    Carlsson, Anna; Pipkorn, Linda; Kullgren, Anders; Svensson, Mats

    2017-05-19

    Whiplash-associated disorder (WAD), commonly denoted whiplash injury, is a worldwide problem. These injuries occur at relatively low changes of velocity (typically Saab Active Head Restraint (SAHR) being one of the most prominent. The SAHR-which is height adjustable-is mounted to a pressure plate in the seatback by means of a spring-resisted link mechanism.  Nevertheless, studies have shown that seats equipped with reactive head restraints (such as the SAHR) have a very high injury-reducing effect for males (∼60-70%) but very low or no reduction effect for females. One influencing factor could be the position of the head restraint relative to the head, because a number of studies have reported that adjustable head restraints often are incorrectly positioned by drivers.  The aim was to investigate how female and male Saab drivers adjust the seat in the car they drive the most. The seated positions of drivers in stationary conditions have been investigated in a total of 76 volunteers (34 females, 42 males) who participated in the study. Inclusion criteria incorporated driving a Saab 9-3 on a regularly basis. The majority of the volunteers (89%) adjusted the head restraint to any of the 3 uppermost positions and as many as 59% in the top position.  The average vertical distance between the top of the head and the top of the head restraint (offset) increase linearly with increasing statures, from an average of -26 mm (head below the head restraint) for small females to an average of 82 mm (head above the head restraint) for large males. On average, the offset was 23 mm for females, which is within a satisfactory range and in accordance with recommendations; the corresponding value for males was 72 mm.  The backset tended to be shorter among female volunteers (on average 27 mm) compared to the male volunteers (on average 44 mm). Moreover, the backset tended to increase with increasing statures. Incorrect adjustment of the head restraint cannot explain

  16. Nurses using physical restraints: Are the accused also the victims? – A study using focus group interviews

    Directory of Open Access Journals (Sweden)

    Lai Claudia KY

    2007-07-01

    knowledge about the use of restraints and its associated adverse effects. These studies, however, fail to note that nurses can also be victims of the system. Restraint use is a complex issue that needs to be understood in relation to the dynamics within an environment.

  17. Influence assessment of the of passive restraint system devices of the passenger locomotive on its dynamic loading during accidenton the railroad

    Directory of Open Access Journals (Sweden)

    N.E.Naumenko

    2013-02-01

    Full Text Available The purpose. To evaluate the work of passenger locomotive protective devices in the test scenarios of collisions adopted in the Russian requirements to the passive safety system. Methodology. Minimization of the effects of incident collisions is done by inclusion of the passive safety devices designed to absorb the kinetic energy of collision in the car bodies bearing constructions. To estimate the maximum accelerations of the train, as well as the compressing longitudinal forces arising in the intercar connection during collisions the discrete mass model of the train is used. Interaction of the train cars was simulated by introducing intercar connections. Findings. At collision of a locomotive at 20 km/h speed (both in separate and in standard train, which does not have a passive safety system, with a vehicle of 10 tones weight the plastic deformations in the locomotive structural elements are observed. At collision of a locomotive with a vehicle, which a mass is comparable to the mass of the loaded car, the plastic deformations in the locomotive structural elements occur at the 10 km/h speed of collision. Originality. It is shown that to decrease the maximum longitudinal force occurring between the locomotive and an obstacle like a freight car of 80 tons mass to the standard value it is necessary to equip the end parts of locomotive with safety devices, which deformation is about 1.5 m. Practical value. To preserve the car structures integrity and passengers, staff and locomotive brigade safety at the incident collisions, a new generation passenger locomotives have to be equipped with the passive safety system devices. On this basis, it is necessary to conduct further researches in the field of passive safety systems for carriages.

  18. Parents' attitudes, knowledge and behaviours relating to safe child occupant travel.

    Science.gov (United States)

    Koppel, Sjaan; Muir, Carlyn; Budd, Laurie; Devlin, Anna; Oxley, Jennie; Charlton, Judith L; Newstead, Stuart

    2013-03-01

    This study investigated parents' attitudes, knowledge and behaviours relating to safe child occupant travel following new Australian legislation regarding child restraint system (CRS) and motor vehicle restraint use for children aged 7 years and under. A questionnaire exploring attitudes, knowledge and behaviours regarding general road safety, as well as safe child occupant travel, was completed by 272 participants with at least one child aged between 3 and 10 years residing in the Australian state of Victoria. Responses to the questionnaire revealed that participants' attitudes, knowledge and behaviours towards road safety in general were fairly positive, with most participants reporting that they restrict their alcohol consumption or do not drink at all while driving (87%), drive at or below the speed limit (85%) and 'always' wear their seatbelts (98%). However, more than half of the participants reported engaging in distracting behaviours 'sometimes' or 'often' (54%) and a small proportion of participants indicated that they 'sometimes' engaged in aggressive driving (14%). Regarding their attitudes, knowledge and behaviours relating to safe child occupant travel, most participants reported that they 'always' restrain their children (99%). However, there was a surprisingly high proportion of participants who did not know the appropriate age thresholds' to transition their child from a booster seat to an adult seatbelt (53%) or the age for which it is appropriate for their child to sit in the front passenger seat of the vehicle (20%). Logistic regression analyses revealed that parents' knowledge regarding safe child occupant travel was significantly related to their attitudes, knowledge and behaviours towards road safety in general, such as drinking habits while driving and CRS safety knowledge. Based on the findings of this study, a number of recommendations are made for strategies to enhance parents' attitudes, knowledge and behaviours relating to safe child

  19. Robustness Improvement of ARA Kevlar Holddown Restraint Cables

    Science.gov (United States)

    Bongers, E.; Koning, J.; Konink, T.

    2013-09-01

    Dutch Space has developed a Hold Down and Release System based on Kevlar Restraint cables and Thermal Knife release in the early nineties of the previous century. The system has been qualified for application in the company's solar array families ARA and FRED for GEO, LEO, MEO and scientific deep space missions comprising solar panel stacks ranging from 2 to 6 panels. Beside solar arrays, derivatives of the HDRS have been used for antenna, cooler and experiment cover hold down and release. Over 500 HDRS units have performed with 100% success in space.Today's missions do not differ much in nominal conditions but more extreme failure modes are specified resulting in more extreme temperatures. The restraint cables, which are exposed directly to these limits of the thermal environment, have been upgraded to cope with the new requirements. An extended life time acceleration test program has been defined and executed to demonstrate their robustness.The qualified upper temperature of the system, the most critical one concerning loads, has been increased from 105°C to 125°C.The paper will describe problems experienced at high temperatures, the new design, supporting engineering tests, the measurement of tension distribution in the cables with Raman spectroscopy, and the accelerated test program and its results.Kevlar cables according to this new design are now baseline for solar arrays of the ESA programs Sentinel- 1, Sentinel-2, Galileo FOC, EarthCARE and Aeolus.

  20. Options for Improving the Military Child Care System

    Science.gov (United States)

    2008-01-01

    military parents use parental care, our analysis of survey responses revealed that most of these are families headed by an unmarried male military...children while the parent or parents were working or going to school. Parental care (care provided by the mother or father) was an option that could...by the child’s mother , a finding that suggests that at least some single military parents do have other child care options available to them and are

  1. A national study of male involvement among families in contact with the child welfare system.

    Science.gov (United States)

    Bellamy, Jennifer L

    2009-08-01

    Few studies inform the frequency and type of adult male involvement in families in contact with child welfare, and even fewer explore how male involvement relates to child welfare outcomes. This study employed data from a sample of 3,978 families in contact with the U.S. child welfare system, drawn from the National Survey of Child and Adolescent Well-Being. The nature of male involvement in these families and its relationship to (a) caseworkers' perception of children's risk for maltreatment rereport and (b) entry into out-of-home care were explored. Results indicate that most caregivers report male involvement, distinct types of male involvement are related to the likelihood of out-of-home care, and households that include nonparental adult males are perceived by caseworkers as relatively risky. No male involvement indicator tested, however, was related to maltreatment rereport. Implications include the need to appropriately assess, include, and engage adult male family members across diverse family systems.

  2. Forensic, Cultural, and Systems Issues in Child Sexual Abuse Cases--Part 2: Research and Practitioner Issues

    Science.gov (United States)

    Tishelman, Amy C.; Geffner, Robert

    2010-01-01

    This article introduces the second issue of the special double issue focusing on forensic, cultural, and systems issues in child sexual abuse cases. We briefly review the articles, which include a discussion of child sexual abuse myths, an empirical analysis of extended child sexual abuse evaluations, an article on the role of the medical provider…

  3. Forensic, Cultural, and Systems Issues in Child Sexual Abuse Cases--Part 2: Research and Practitioner Issues

    Science.gov (United States)

    Tishelman, Amy C.; Geffner, Robert

    2010-01-01

    This article introduces the second issue of the special double issue focusing on forensic, cultural, and systems issues in child sexual abuse cases. We briefly review the articles, which include a discussion of child sexual abuse myths, an empirical analysis of extended child sexual abuse evaluations, an article on the role of the medical provider…

  4. Striving for Balance Between Caring and Restraint

    DEFF Research Database (Denmark)

    Moberg, Julie Y; Larsen, Dorte; Brødsgaard, Anne

    2016-01-01

    with 14 young adults were conducted. RESULTS: The essence of the phenomenon of having a parent with multiple sclerosis was synthesized into 'Striving for balance between caring and restraint' from two themes 'caring' and 'restraint' and eight subthemes. Participants' experiences of caring for parents...... that one of the greatest challenges of having a parent with multiple sclerosis is achieving a balance between caring for others and asserting one's own desires. RELEVANCE TO CLINICAL PRACTICE: Health care professionals can support the family by encouraging family members to participate in consultations...... and to assist the parents in providing information about multiple sclerosis and its symptoms to the children. Parents might need assistance in applying for help with domestic chores or referrals to support groups for their children or other family members. This article is protected by copyright. All rights...

  5. Development and psychometric properties of the Smoking Restraint Questionnaire.

    Science.gov (United States)

    Blake, Grant A; Ferguson, Stuart G; Palmer, Matthew A; Shiffman, Saul

    2016-03-01

    Restraint is a component of self-control that focuses on the deliberate reduction of an undesired behavior and is theorized to play a role in smoking reduction and cessation. However, there exists no instrument to assess smoking restraint. This research aimed to develop the Smoking Restraint Questionnaire (SRQ) to meet this need. Participants were 406 smokers (48% female; 52.2% nondaily) with a mean age of 38.83 years (SD = 12.05). They completed a baseline questionnaire designed to assess smoking restraint. They also completed 21 days of ecological momentary assessment (EMA), during which they recorded each cigarette smoked and answered questions related to planned restraint every morning, and restraint attempts every evening. The 4-item questionnaire of smoking restraint was found to fit a single factor (root mean square error of approximation = .038, comparative fit index = .99, Tucker-Lewis index = .99), and the resulting composite was reliable (composite reliability = 0.74). The questionnaire contains items that assess the setting of weekly restraint goals and attempts at not lighting up when tempted to smoke. Participant SRQ scores positively correlated with EMA data on plans to restrain (p < .001) and frequency of restraint attempts (p < .001). These correlations suggest that the SRQ has good predictive validity in relation to the intention and behaviors of smoking reduction. The SRQ is promising as a measure of smoking restraint and may enable further research and insights into smoking reduction and cessation.

  6. Substance abuse interventions for parents involved in the child welfare system: evidence and implications.

    Science.gov (United States)

    Osterling, Kathy Lemon; Austin, Michael J

    2008-01-01

    As child welfare systems across the country face the problem of parental substance abuse, there is an increasing need to understand the types of treatment approaches that are most effective for substance-abusing parents in the child welfare system-the majority of whom are mothers. This structured review of the literature focuses on evidence related to two areas: (1) individual-level interventions designed to assist mothers and women in addressing their substance abuse problems, and (2) system-level interventions designed to improve collaboration and coordination between the child welfare system and the alcohol and other drug system. Overall, research suggests the following program components may be effective with substance-abusing women with children: (1) Women-centered treatment that involves children, (2) Specialized health and mental health services, (3) Home visitation services, (4) Concrete assistance, (5) Short-term targeted interventions, and (6) Comprehensive programs that integrate many of these components. Research also suggests that promising collaborative models between the child welfare system (CWS) and the alcohol and other drug (AOD) system typically include the following core elements: (1) Out-stationing AOD workers in child welfare offices, (2) Joint case planning, (3) Using official committees to guide collaborative efforts, (4) Training and cross-training, (5) Using protocols for sharing confidential information, and (6) Using dependency drug courts. Although more rigorous research is needed on both individual-level and system-level substance abuse interventions for parents involved in the child welfare system, the integration of individual-level interventions and system-level approaches is a potentially useful practice approach with this vulnerable population.

  7. Measuring parent-child mutuality: a review of current observational coding systems.

    Science.gov (United States)

    Funamoto, Allyson; Rinaldi, Christina M

    2015-01-01

    Mutuality is defined as a smooth, back-and-forth positive interaction consisting of mutual enjoyment, cooperation, and responsiveness. The bidirectional nature of mutuality is an essential component to the parent-child relationship since a high quality parent-child mutual relationship is crucial to encouraging children's positive socialization and development (S. Lollis & L. Kuczynski, 1997; E.E. Maccoby, 2007). Several coding systems have been developed in recent years to assess this distinct and crucial aspect of the parent-child relationship. The present article reviews the following four mutuality coding schemes: the Parent-Child Interaction System (K. Deater-Deckard, M.V. Pylas, & S. Petrill, 1997), the Mutually Responsive Orientation Scale (N. Aksan, G. Kochanska, & M.R. Ortmann, 2006), the Caregiver-Child Affect, Responsiveness, and Engagement Scale (C.S. Tamis-LeMonda, P. Ahuja, B. Hannibal, J.D. Shannon, & M. Spellmann, 2002), and the Synchrony and Control Coding Scheme (J. Mize & G.S. Pettit, 1997). The review will focus on observational coding schemes available to researchers interested a central element of quality parent-child relationships in the early years.

  8. The Effect of a Restraint Reduction Program on Physical Restraint Rates in Rehabilitation Settings in Hong Kong

    Directory of Open Access Journals (Sweden)

    Claudia K. Y. Lai

    2011-01-01

    Full Text Available Background. In view of the adverse effects of using restraints, studies examining the use of restraint reduction programs (RRPs are needed. Objectives. To investigate the effect of an RRP on the reduction of physical restraint rates in rehabilitation hospitals. Methods. A prospective quasi-experimental clinical trial was conducted. Demographic data, medical and health-related information on recruited patients from two rehabilitation hospitals, as well as facility data on restraint rates were collected. Results. The increase in the restraint rate in the control site was 4.3 times greater than that in the intervention site. Changes in the restraint mode, from continuous to intermittent, and the type of restraint used were found between the pre- and postintervention periods in both the control site and the intervention site. Discussion. Compared with that in the control site, the RRP in the intervention site helped arrest any increase in the restraint rate although it had no effect on physical restraint reduction. The shift of restraint mode from continuous to intermittent in the intervention site was one of the positive outcomes of the RRP.

  9. Development and evaluation of an expert system for the diagnosis of child autism.

    Science.gov (United States)

    Lialiou, Pashalina; Zikos, Dimitrios; Mantas, John

    2012-01-01

    This paper presents the development of an expert system for the diagnosis of child autism and discusses potential benefits of its implementation in a clinical environment. The development of the expert system was based on a diagnostic algorithm supported by a developmental scale (PEDS) and a diagnostic tool of autism (CARS). Twelve nurses who work in pediatric hospital were asked to use the expert system for a session of 30 minutes and were asked to assess its usefulness, usability and diagnostic value. The majority of nurses agree that it is a useful and promising diagnostic tool for the clinical practice and for the identification of potential child autism cases.

  10. Physical Restraint Procedures for Managing Challenging Behaviours Presented by Mentally Retarded Adults and Children.

    Science.gov (United States)

    Harris, John

    1996-01-01

    The literature on the use of physical restraint with adults and children with mental retardation is reviewed, including person-to-person restraint, mechanical devices, and voluntary self-restraint. Conclusions regarding outcomes of contingent and noncontingent restraint, maintenance, reinforcing effects of restraint, and risk of injury are…

  11. Staff resistance to restraint reduction: identifying & overcoming barriers.

    Science.gov (United States)

    Curran, Staci Silver

    2007-05-01

    Professional organizations, regulating agencies, and hospital administrators have taken a strong stance on restraint reduction policies. When implementing a restraint reduction initiative, it is important to identify the barriers to restraint reduction, such as concern for personal safety, lack of knowledge about and practice using alternate de-escalation skills, and fear of disrupting the therapeutic milieu by using a variety of de-escalation methods. Education aimed to reduce the use of restraints needs to do more than simply provide information. It is important to acknowledge the emotional response of the nursing staff and the culture of the current practice. A variety of educational strategies, including role-playing, and case studies will help identify attitudes, beliefs, and behaviors that are congruent with reducing the use of restraints. If the ultimate goal of restraint reduction is philosophical change, it will eventually lead to a new culture of practice.

  12. Kinematics and shoulder belt position of child rear seat passengers during vehicle maneuvers.

    Science.gov (United States)

    Bohman, Katarina; Stockman, Isabelle; Jakobsson, Lotta; Osvalder, Anna-Lisa; Bostrom, Ola; Arbogast, Kristy B

    2011-01-01

    Head impact to the seat back has been identified as one important injury causation scenario for seat belt restrained, head-injured children and previous research highlighted vehicle maneuvers prior to impact as possible contributing factors. The aim was to quantify kinematics of child occupants during swerving maneuvers focusing on the child's lateral movement and seat belt position relative to the child's shoulder. A study was conducted on a closed-circuit test track with 16 children aged 4-12, restrained in the rear seat of a modern passenger vehicle. A professional driving instructor drove at 50 km/h making sharp turns in a repeatable fashion, resulting in inboard motion of the children. The children were exposed to two turns in each of two restraint systems. Shorter children were on a booster or highback booster cushion. The taller children were seated on a booster cushion or with only a lap and shoulder seat belt. Four film cameras were fixed in the vehicle monitoring the child. Vehicle data were also collected. The seat belt slipped off the shoulder in 1 of 5 turns, varying by age and restraint type. Among shorter children, the belt slipped off in a majority of turns when seated on a booster cushion while the belt remained on the shoulder when seated on the highback booster cushion. Among taller children, the shoulder belt moved far laterally on the shoulder in half of the turns. This data provides valuable knowledge on possible pre-impact postures of children as a result of vehicle swerving maneuvers for a variety of restraint systems.

  13. A Grassroots Prototype for Trauma-Informed Child Welfare System Change

    Science.gov (United States)

    Henry, James; Richardson, Margaret; Black-Pond, Connie; Sloane, Mark; Atchinson, Ben; Hyter, Yvette

    2011-01-01

    The development of trauma-informed child welfare systems (TICWSs) that advance individual agency practice to target transformation of the system as a whole has been conceptualized but not documented. A grassroots effort to build a TICWS with key participants (e.g., Department of Human Services, Community Mental Health, Family Court, schools) in…

  14. Psychiatric Nurses' Perceptions about Physical Restraint; A Qualitative Study.

    Science.gov (United States)

    Fereidooni Moghadam, Malek; Fallahi Khoshknab, Masoud; Pazargadi, Mehrnoosh

    2014-01-01

    The use of physical restraint as an intervention in the care of psychiatric patients dates back to the beginning of psychiatry. Although it is a challenging question, it is still one of the common procedures in psychiatry. Considering that very little research has been done in Iran in relation to physical restraint, this qualitative study aimed to investigate the experiences of  nurses working in psychiatric wards regarding physical restraint. This qualitative study was done on 14 nurses working in the psychiatric hospitals of Ahvaz city, southern Iran, during 2011-2012. The participants were selected by purposive sampling. Semi-structured interviews were used for data collection, which were continued until data saturation and emergence of themes. Inductive content analysis was used to analyze the data. Four categories emerged: (1) Restraint as a multi-purpose procedure, (2) Processing of physical restraint, (3) Restraint as a challenging subject and (4) The effects of restraint on the spectrum. Each category has several different sub-categories. The participants described using physical restraint as one of the main strategies to control psychiatric patients, and despite having negative consequences, it is extensively used. Given the risks and challenges of using physical restraint, nursing education should find alternative methods.

  15. Nurses' perceptions and practice of physical restraint in China.

    Science.gov (United States)

    Jiang, Hui; Li, Chen; Gu, Yan; He, Yanan

    2015-09-01

    There is controversy concerning the use of physical restraint. Despite this controversy, some nurses still consider the application of physical restraint unavoidable for some of their clients. Identify the perceptions and practice of physical restraint in China. This was a descriptive study that combined qualitative interviews with a quantitative cross-sectional survey. A total of 18 nurses were interviewed and 330 nurses were surveyed. Approval of the study was obtained from the hospital ethics committee. Permission to conduct the study was obtained from the director of nursing. Participants were assured that their participation is voluntary. Physical restraint was commonly used to protect patients' safety. Naturally, intensive care unit nurses used physical restraint much more frequently than general medical/surgical ward nurses (p < 0.01). In addition, night shift nurses tended to use physical restraint more frequently. Nursing managers should be aware of the role nurses play in the use of physical restraint. In-service training regarding the proper use of physical restraint should be strengthened and nurse staffing levels should be improved in order to minimize the use of physical restraint in China. © The Author(s) 2014.

  16. Child cancer follow-up ontology and information system

    DEFF Research Database (Denmark)

    El-Subaihi, J.A.; Anton, François; Mioc, Darka

    2013-01-01

    brings the methodology for child cancer treatment plan that produces an ontology to create a conceptual model and a database model. To construct the ontology, the "methontology" method is used as a structured approach for the ontology process. The method guides the ontology developer from scratch...... to building a complete model. The ontology is developed in two phases. In the first phase, research from other countries and process models are reviewed and the generic model is built from this research. The generic model is adapted to the ontology for the Danish hospitals including the NOPHO-ALL 2008...... protocol. To develop the ontology, a data dictionary is first proposed. Then, the relationships between concepts are identified and verified: the oriented graph, where nodes are concepts and oriented edges are dependence relationships, where the definition of the concept at the origin of the edge depends...

  17. Design of child's safety management system based on ontology using context information of home network

    Institute of Scientific and Technical Information of China (English)

    Hye-Kyoung Jeon; Jung-Hyun Lee; Kee-Wook Rim; Yang-Jae Park

    2007-01-01

    This paper presents a system to alert of dangerous a child situation of a child by applying context information collected from a home network to ontology that is capable of inference. Radio frequency Identification (RFID) and sensors were used for the configuration of a home network, to obtain the raw data to convert into context information. To express the ontology, web ontology language (OWL) was used to provide the inference of context information. Then, simple object access protocol (SOAP) messages were used to notify of the dangerous situations that a child may be involved in via mobile devices. The proposed system consists of Context Manager, Service Manager, and Notification Manager. The child's safety management system can proactively detect the context data of a child on the basis of context awareness. In the experiment, the Jena 2.0 by ontology reasoner and the OSGi(Open Service Gateway initiative) Gateway developed using open source software Knopflerfish 1.3.3 were used to implement the service frame work.

  18. Measuring dietary restraint status: Comparisons between the Dietary Intent Scale and the Restraint Scale

    Directory of Open Access Journals (Sweden)

    Jessica A Boyce

    2015-04-01

    Full Text Available The measurement of young women’s self-reported dietary restraint status is complex. Compared to Herman and Polivy’s commonly utilized Restraint Scale (RS, Stice’s Dietary Intent Scale (DIS is less understood. Because the DIS is becoming a popular research tool, it is important to understand how this scale compares to more traditional measures of restraint. We conducted two correlational studies (Study 1 N = 110; Study 2 N = 216 to ascertain the similarities and the differences between the DIS and - as a comparison measure - the well-researched RS. We explored how the two scales were related to several body image variables (e.g., thin-ideal internalization; with a range of self-regulatory variables (e.g., dispositional self-control; with observed food intake during a taste test; and with 18-month weight change (Study 2 only. Participants were female University students and were not selected for dieting or disordered eating. Unlike RS scores, DIS scores were not significantly correlated with the majority of variables tapping into unsuccessful self-regulation. However, our data also highlighted similarities between the two restraint scales (e.g., association with 18-month weight-loss and demonstrated that not only were participants’ DIS scores un-related to unsuccessful self-regulatory variables, neither were they related to the variables tapping into successful self-regulation.

  19. The restraint bias: how the illusion of self-restraint promotes impulsive behavior

    NARCIS (Netherlands)

    Nordgren, L.F.; van Harreveld, F.; van der Pligt, J.

    2009-01-01

    Four studies examined how impulse-control beliefs—beliefs regarding one's ability to regulate visceral impulses, such as hunger, drug craving, and sexual arousal—influence the self-control process. The findings provide evidence for a restraint bias: a tendency for people to overestimate their capaci

  20. Dual-System Families: Cash Assistance Sequences of Households Involved with Child Welfare.

    Science.gov (United States)

    Kang, JiYoung; Romich, Jennifer L; Hook, Jennifer L; Lee, JoAnn S; Marcenko, Maureen

    2016-01-01

    Dual-system families, those involved with the child welfare system and receiving public cash assistance, may be more vulnerable than families only connected to either of the two systems. This study advances our understanding of the heterogeneous and dynamic cash assistance histories of dual-system families in the post-welfare reform era. With merged administrative data from [state name removed] over the period 1998 to 2009, we use cluster analysis to group month-to-month sequences of cash assistance use among households over the 37-month period surrounding child removal. Close to two thirds of families who received any assistance either had a short spell of Temporary Assistance for Needy Families (TANF) or lost TANF. Smaller percentages had steady support. Families who lose assistance are less likely than average to reunify while those who connect to benefits are more likely, suggesting coordination between systems may serve dual-system families well.

  1. Aceh Free Pasung: Releasing the mentally ill from physical restraint

    Directory of Open Access Journals (Sweden)

    Marthoenis M

    2011-05-01

    Full Text Available Abstract Background Physical restraint and confinement of the mentally ill (called pasung in Indonesia is common in Aceh. In early 2010, the local government initiated a program called Aceh Free Pasung 2010. The main goal of the program is to release the mentally ill in the province from restraint and to provide appropriate medical treatment and care. The aim of the paper is to report the findings of a preliminary investigation of the demographic and clinical characteristics of patients who have been admitted to the Banda Aceh Mental Hospital as part of the Aceh Free Pasung program. Methods This is a cross-sectional descriptive study conducted at the Banda Aceh Mental Hospital, where people who had been restrained or confined in the community are being admitted for psychiatric treatment and, where necessary, physical rehabilitation, as part of the Aceh Free Pasung program. Results Fifty-nine of former ex-pasung patients were examined. The majority (88.1% of the patients were male, aged 18 to 68 years. The duration of pasung varied from a few days to 20 years, with a mean duration of 4.0 years. The reasons for applying pasung are many, with concerns about dangerousness being most common. The great majority (89.8% had a diagnosis of schizophrenia. Discussion The development of a community mental health system and the introduction of a health insurance system in Aceh (together with the national health insurance scheme for the poor has enabled access to free hospital treatment for people with severe mental disorders, including those who have been in pasung. The demographic and clinical characteristics of this group of ex-pasung patients are broadly similar to those reported in previous studies. Conclusions The Aceh Free Pasung program is an important mental health and human rights initiative that can serve to inform similar efforts in other parts of Indonesia and other low and middle-income countries where restraint and confinement of the mentally

  2. MRI changes in the central nervous system in a child with lupus erythematosus

    Energy Technology Data Exchange (ETDEWEB)

    Gieron, M.A. [Dept. of Pediatrics, Univ. of South Florida, Coll. of Medicine, Tampa, FL (United States); Khoromi, S. [Dept. of Neurology, Univ. of South Florida, Coll. of Medicine, Tampa, FL (United States); Campos, A. [Dept. of Pediatrics, Univ. of South Florida, Coll. of Medicine, Tampa, FL (United States)

    1995-05-01

    We report on a 10-year-old girl with systemic lupus erythematosus who presented in status epilepticus as the only manifestation of central nervous system involvement. MRI of the brain showed diffuse gray and white matter lesions which almost completely resolved after treatment with methylprednisolone. MRI findings in this child are similar to those in adults with diffuse clinical manifestations. The study is essential in the initial evaluation of patients suspected of central nervous system lupus. (orig.)

  3. PSYCHOLOGICAL MODEL OF THE SYSTEM "SPECIAL CHILD – LIVING ENVIRONMENT" AS A BASIS FOR SUPPORT OF CHILDREN WITH DISABILITIES

    Directory of Open Access Journals (Sweden)

    Светлана Анатольевна Калашникова

    2013-04-01

    Full Text Available This work is aimed to determine the content characteristic of interaction of a child with disabilities and his living environment, psychological analysis of the options for the child development in different types of this interaction. It is based on the principles of system analysis. Child development is presented as a process and the result of interaction between the system components "child with disabilities – living environment". Interaction is considered in terms of compliance, non-compliance of system components.The article identifies the types of system interactions "special child – living environment" (adaptive, developing, maladaptive, deforming and gives their content characteristics. Integrative potential is considered as a condition, the result and complete description of the system "special child – living environment". It includes the personal potential possibilities of a child with disabilities and the resources of living environment according to the child’s needs.  The presented model is applicable to the analysis of family or  education environment  of disabled child to create and carry out the individual program of child development and creation of optimal conditions for the socialization and integration.DOI: http://dx.doi.org/10.12731/2218-7405-2013-3-13

  4. Mechanical and pharmacological restraints in acute psychiatric wards--why and how are they used?

    Science.gov (United States)

    Knutzen, Maria; Bjørkly, Stål; Eidhammer, Gunnar; Lorentzen, Steinar; Helen Mjøsund, Nina; Opjordsmoen, Stein; Sandvik, Leiv; Friis, Svein

    2013-08-30

    Restraint use has been reported to be common in acute psychiatry, but empirical research is scarce concerning why and how restraints are used. This study analysed data from patients' first episodes of restraint in three acute psychiatric wards during a 2-year study period. Logistic regression analyses were used to identify predictors for type and duration of restraint. The distribution of restraint categories for the 371 restrained patients was as follows: mechanical restraint, 47.2%; mechanical and pharmacological restraint together, 35.3%; and pharmacological restraint, 17.5%. The most commonly reported reason for restraint was assault (occurred or imminent). It increased the likelihood of resulting in concomitant pharmacological restraint. Female patients had shorter duration of mechanical restraint than men. Age above 49 and female gender increased the likelihood of pharmacological versus mechanical restraint, whereas being restrained due to assault weakened this association. Episodes with mechanical restraint and coinciding pharmacological restraint lasted longer than mechanical restraint used separately, and were less common among patients with a personality disorder. Diagnoses, age and reason for restraint independently increased the likelihood for being subjected to specific types of restraint. Female gender predicted type of restraint and duration of episodes.

  5. Console video games, postural activity, and motion sickness during passive restraint.

    Science.gov (United States)

    Chang, Chih-Hui; Pan, Wu-Wen; Chen, Fu-Chen; Stoffregen, Thomas A

    2013-08-01

    We examined the influence of passive restraint on postural activity and motion sickness in individuals who actively controlled a potentially nauseogenic visual motion stimulus (a driving video game). Twenty-four adults (20.09 ± 1.56 years; 167.80 ± 7.94 cm; 59.02 ± 9.18 kg) were recruited as participants. Using elastic bands, standing participants were passively restrained at the head, shoulders, hips, and knees. During restraint, participants played (i.e., controlled) a driving video game (a motorcycle race), for 50 min. During game play, we recorded the movement of the head and torso, using a magnetic tracking system. Following game play, participants answered a forced choice, yes/no question about whether they were motion sick, and were assigned to sick and well groups on this basis. In addition, before and after game play, participants completed the Simulator Sickness Questionnaire, which provided numerical ratings of the severity of individual symptoms. Five of 24 participants (20.83 %) reported motion sickness. Participants moved despite being passively restrained. Both the magnitude and the temporal dynamics of movement differed between the sick and well groups. The results show that passive restraint of the body can reduce motion sickness when the nauseogenic visual stimulus is under participants' active control and confirm that motion sickness is preceded by distinct patterns of postural activity even during passive restraint.

  6. AT89S52 Microcontroller Based A Speed Restraint Equipment for Motorcycle

    Directory of Open Access Journals (Sweden)

    Ikhsan hidayat

    2009-08-01

    Full Text Available Security riding is very important in the aspects of traffic. One of the main factors of traffic accidents is high speed. Therefore, it is required a speed restraint equipment for pressing the number of accidents. The car speed restraint system is available in the market, but on a motorcycle is not available yet. This paper presents a design of speed restraint equipment for motorcycle that safe for users, and is expected to reduce traffic accident. The Main idea this speed restriction is cutting off the flow of electrical signals from the pulser (the time ignition trigger sensor to the CDI for 1 second. The cutting Signal with mechanical relays controlled by microcontroller AT89S52 using the on-off algorithm. Speed sensor use optocoupler is used to detect the number of rounds wheel motorcycle. If a result of measurement is more than the speed setpoint, microcontroler make a decission to cut motorcycle ignition signal. Results of this research is a prototype speed restraint shown that it able to process data from the measurement of the speed limit on the speed of a motorcycle. This prototype safe for all users and accordance with the set value and the level of success is above 90% for speed of 10 km/hr to 40 km/hr.

  7. The Effects of Physical Restraint on Self-Injurious Behaviour.

    Science.gov (United States)

    Singh, N. N.; And Others

    1981-01-01

    Brief (one minute) response contingent physical restraint was shown in two experiments with a 16-year-old profoundly retarded institutionalized girl to be more effective in controlling self-injurious behavior (SIB) than three minute physical restraint, which in the first study produced an increase in SIB. (CL)

  8. High School Students' Publication Rights and Prior Restraint.

    Science.gov (United States)

    Huffman, John L.; Trauth, Denise M.

    1981-01-01

    Federal court decisions on high school students' publication rights in the Second, Fourth, Fifth, and Seventh Circuits reveal substantial disagreement about school officials' power of prior restraint over student publications. The courts' opinions range from approval of broad powers of prior restraint to denial of any power. (Author/RW)

  9. Deep venous thrombosis and pulmonary embolism following physical restraint

    DEFF Research Database (Denmark)

    Laursen, S B; Jensen, T N; Bolwig, T

    2005-01-01

    OBJECTIVE: We describe a case of deep venous thrombosis (DVT) and pulmonary embolism (PE) following the use of physical restraint in a patient with a diagnosis of acute delusional psychotic disorder. METHOD: A new case report of DVT and PE associated with prolonged physical restraint is presented...

  10. Individualized music--a different approach to the restraint issue.

    Science.gov (United States)

    Janelli, Linda M; Kanski, Genevieve W; Wu, Yow-Wu Bill

    2002-01-01

    Rehabilitation nurses who work with geriatric patients are concerned about reliance on physical restraints, as are all nurses. Controversy exists as to the benefits and risks, as well as the ethical and legal consequences, of their use. Nurses are ambivalent about using restraints, believing that they affect patients' freedom, self-respect, and self-reliance; they also often believe that there are no appropriate alternatives. This pilot study explored the use of music as a potential alternative to using physical restraints with hospitalized patients. The research question was: Will patients have more positive behaviors, as measured by the Restraint Music Response Instrument (RMRI), while out of restraints and listening to preferred music compared with the patients not listening to music who are out of restraints while being observed? Forty medical-surgical patients participated in the study and were randomized into either the experimental group (music) or the control group (no music). The mean age of the 21 males and 19 females was 76.6 years (range 56-94). A t test for equality of means was used to determine if there were differences in the number of positive and negative behaviors in the preintervention, intervention, and postintervention phases between the two groups. There was a significant difference (p < .01) in behaviors during the intervention phase. Patients who listened to preferred music had more positive behaviors while out of restraints than patients who were out of restraints but not exposed to music.

  11. 30 CFR 56.9301 - Dump site restraints.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Dump site restraints. 56.9301 Section 56.9301 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND NONMETAL MINE... § 56.9301 Dump site restraints. Berms, bumper blocks, safety hooks, or similar impeding devices...

  12. 28 CFR 570.44 - Supervision and restraint requirements.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Supervision and restraint requirements... PROGRAMS AND RELEASE COMMUNITY PROGRAMS Escorted Trips § 570.44 Supervision and restraint requirements. Inmates under escort will be within the constant and immediate visual supervision of escorting staff...

  13. Dietary restraint moderates genetic risk for binge eating.

    Science.gov (United States)

    Racine, Sarah E; Burt, S Alexandra; Iacono, William G; McGue, Matt; Klump, Kelly L

    2011-02-01

    Dietary restraint is a prospective risk factor for the development of binge eating and bulimia nervosa. Although many women engage in dietary restraint, relatively few develop binge eating. Dietary restraint may increase susceptibility for binge eating only in individuals who are at genetic risk. Specifically, dietary restraint may be a behavioral exposure factor that activates genetic predispositions for binge eating. We investigated this possibility in 1,678 young adolescent and adult same-sex female twins from the Minnesota Twin Family Study and the Michigan State University Twin Registry. Twin moderation models were used to examine whether levels of dietary restraint moderate genetic and environmental influences on binge eating. Results indicated that genetic and nonshared environmental factors for binge eating increased at higher levels of dietary restraint. These effects were present after controlling for age, body mass index, and genetic and environmental overlap among dietary restraint and binge eating. Results suggest that dietary restraint may be most important for individuals at genetic risk for binge eating and that the combination of these factors could enhance individual differences in risk for binge eating.

  14. 75 FR 67233 - Federal Motor Vehicle Safety Standards; Head Restraints

    Science.gov (United States)

    2010-11-02

    ... Positions b. Leadtime for Small Vehicle Manufacturers c. Static Lockout of Active Head Restraints During.... Petitions for Rulemaking a. Discomfort Metric for Non-Use Position and Relaxation Requirement for Gap b... of Active Head Restraints During Backset Retention Testing 1. NHTSA Agrees To Specify the Fixation...

  15. Child Abuse and Autonomic Nervous System Hyporesponsivity among Psychiatrically Impaired Children

    Science.gov (United States)

    Ford, Julian D.; Fraleigh, Lisa A.; Albert, David B.; Connor, Daniel F.

    2010-01-01

    Objective: Sexually or physically abused children are at risk for neurobiological dysregulation as well as for internalizing and disruptive behavior disorders. Stress-related autonomic nervous system (ANS) down-regulation has been proposed as a sequela of abuse and was investigated in the present study. Methods: Child Protective Services…

  16. Fire Setting Behavior in a Child Welfare System: Prevalence, Characteristics and Co-Occurring Needs

    Science.gov (United States)

    Lyons, John S.; McClelland, Gary; Jordan, Neil

    2010-01-01

    Fire setting is one of the most challenging behaviors for the child welfare system. However, existing knowledge about its prevalence and correlates has been limited to research on single programs. The Illinois Department of Children and Family Services initiated a uniform assessment process at entry into state custody using a trauma-informed…

  17. Progress Report on the Development of Child Abuse Prevention, Identification, and Treatment Systems in Eastern Europe

    Science.gov (United States)

    Lewis, Owen; Sargent, John; Chaffin, Mark; Friedrich, William N.; Cunningham, Nicholas; Cantor, Pamela; Coffey, Pamela Sumner; Villani, Susan; Beard, Philip R.; Clifft, Mary Ann; Greenspun, David

    2004-01-01

    Problem: After the Soviet Union dissolved in 1989, it became apparent that there was little recognition of the problems of child abuse and neglect, professionally, legally, or societally. There were no effective systems or laws in place to deal with these problems. Method: Beginning in 1995 the Children's Mental Health Alliance, in conjunction…

  18. Child Abuse and Autonomic Nervous System Hyporesponsivity among Psychiatrically Impaired Children

    Science.gov (United States)

    Ford, Julian D.; Fraleigh, Lisa A.; Albert, David B.; Connor, Daniel F.

    2010-01-01

    Objective: Sexually or physically abused children are at risk for neurobiological dysregulation as well as for internalizing and disruptive behavior disorders. Stress-related autonomic nervous system (ANS) down-regulation has been proposed as a sequela of abuse and was investigated in the present study. Methods: Child Protective Services…

  19. Virginia Star Quality Initiative: QRS Profile. The Child Care Quality Rating System (QRS) Assessment

    Science.gov (United States)

    Child Trends, 2010

    2010-01-01

    This paper presents a profile of Virginia's Star Quality Initiative prepared as part of the Child Care Quality Rating System (QRS) Assessment Study. The profile consists of several sections and their corresponding descriptions including: (1) Program Information; (2) Rating Details; (3) Quality Indicators for Center-Based Programs; (4) Indicators…

  20. Delaware Stars for Early Success. QRS Profile. The Child Care Quality Rating System (QRS) Assessment

    Science.gov (United States)

    Child Trends, 2010

    2010-01-01

    This paper presents a profile of Delaware's Stars for Early Success prepared as part of the Child Care Quality Rating System (QRS) Assessment Study. The profile consists of several sections and their corresponding descriptions including: (1) Program Information; (2) Rating Details; (3) Quality Indicators for Center-Based Programs; (4) Indicators…

  1. Kentucky STARS for KIDS NOW: QRS Profile. The Child Care Quality Rating System (QRS) Assessment

    Science.gov (United States)

    Child Trends, 2010

    2010-01-01

    This paper presents a profile of Kentucky's STARS for KIDS NOW prepared as part of the Child Care Quality Rating System (QRS) Assessment Study. The profile consists of several sections and their corresponding descriptions including: (1) Program Information; (2) Rating Details; (3) Quality Indicators for Center-Based Programs; (4) Indicators for…

  2. Pennsylvania Keystone STARS: QRS Profile. The Child Care Quality Rating System (QRS) Assessment

    Science.gov (United States)

    Child Trends, 2010

    2010-01-01

    This paper presents a profile of Pennsylvania's Keystone STARS prepared as part of the Child Care Quality Rating System (QRS) Assessment Study. The profile consists of several sections and their corresponding descriptions including: (1) Program Information; (2) Rating Details; (3) Quality Indicators for Center-Based Programs; (4) Indicators for…

  3. Addressing Substance Abuse Treatment Needs of Parents Involved with the Child Welfare System

    Science.gov (United States)

    Oliveros, Arazais; Kaufman, Joan

    2011-01-01

    The goal of this paper is to synthesize available data to help guide policy and programmatic initiatives for families with substance abuse problems who are involved with the child welfare system, and identify gaps in the research base preventing further refinement of practices in this area. To date, Family Treatment Drug Court and newly developed…

  4. Court-Appointed Special Advocate Strong Beginnings: Raising Awareness across Early Childhood and Child Welfare Systems

    Science.gov (United States)

    Corr, Catherine; Danner, Natalie

    2014-01-01

    Abuse or neglect and disability often go hand in hand. Unfortunately, most professionals who work with maltreated young children are not aware of early childhood and disability-related resources and services available. In order to raise awareness across early childhood and child welfare systems, a five-week advanced training for volunteer child…

  5. Child Maltreatment Fatalities in Children under 5: Findings from the National Violence Death Reporting System

    Science.gov (United States)

    Klevens, Joanne; Leeb, Rebecca T.

    2010-01-01

    Objective: To describe the distribution of child maltreatment fatalities of children under 5 by age, sex, race/ethnicity, type of maltreatment, and relationship to alleged perpetrator using data from the National Violent Death Reporting System (NVDRS). Study design: Two independent coders reviewed information from death certificates, medical…

  6. Fire Setting Behavior in a Child Welfare System: Prevalence, Characteristics and Co-Occurring Needs

    Science.gov (United States)

    Lyons, John S.; McClelland, Gary; Jordan, Neil

    2010-01-01

    Fire setting is one of the most challenging behaviors for the child welfare system. However, existing knowledge about its prevalence and correlates has been limited to research on single programs. The Illinois Department of Children and Family Services initiated a uniform assessment process at entry into state custody using a trauma-informed…

  7. NMDA antagonist MK 801 in nucleus accumbens core but not shell disrupts the restraint stress-induced reinstatement of extinguished cocaine-conditioned place preference in rats.

    Science.gov (United States)

    De Giovanni, Laura N; Guzman, Andrea S; Virgolini, Miriam B; Cancela, Liliana M

    2016-12-15

    Relapse is a common feature of cocaine addiction. In rodents, it can be elicited by cues, stress or the drug. Restraint stress-induced reinstatement of cocaine-conditioned place preference (CPP) is a useful model to study the mechanisms involved in stress-induced relapse of drug-seeking behavior. There is evidence that the glutamate NMDA receptors are critically involved in drug- and cue-induced reinstatement of seeking behavior and drug-CPP responses. The aim of this study was to investigate the contribution of NMDA receptors within core vs. shell nucleus accumbens (NAc) subregions to restraint stress-induced reinstatement of extinguished cocaine-CPP. After extinction of cocaine-conditioned preference, animals were administered MK 801 systemically or directly into intra-core or intra-shell, and restrained for 30min or left undisturbed in their home-cages. First, we demonstrated that restraint stress-induced reinstatement of extinguished cocaine-CPP depends on the duration of restraint as well as on the context in which it is applied. Second, this effect was blocked by systemic MK 801 administration either before or after restraint. Third, intra-core but not intra-shell administration abrogated the restraint stress-induced reinstatement. These findings show that NMDA receptors within NAc core, but not shell, play a critical role in restraint stress-induced reinstatement of cocaine-CPP.

  8. The Value Of Justice In Child Criminal Justice System A Review Of Indonesian Criminal Law

    Directory of Open Access Journals (Sweden)

    Andi Sofyan

    2015-08-01

    Full Text Available The value of justice in Act No. 11 of 2012 concerns the Child Criminal Justice System Act No. SPPA confirms the Restorative Justice Approach as a method of disputes resolution. The method of research used was normative-legal research with philosophical approach. The results showed that the value of restorative justice through diversion contained in Act SPPA but the diversion limit for certain types of criminal acts and threats of punishment under seven 7 years and not a repetition criminal recidivists. This indicates that Act SPPA still contained a retributive justice not promote the interests of protection for child.

  9. Agency Culture and Climate in Child Welfare: Do Perceptions Vary by Exposure to the Child Welfare System?

    Science.gov (United States)

    Spielfogel, Jill E; Leathers, Sonya J; Christian, Errick

    2016-01-01

    Organizational culture and climate play a critical role in worker retention and outcomes, yet little is known about whether perceptions of culture and climate vary depending on the demands of particular roles. In this study, 113 staff from a child welfare agency completed Organizational Social Context profiles. Staff were divided into three groups according to their proximity to child welfare tasks to assess whether involvement in higher stress child welfare tasks is related to perceptions of the social context. Findings suggest possible differences across groups, with those involved in core child welfare tasks appearing to perceive higher resistance to new ways of providing services and those with the least involvement in traditional child welfare perceiving a more positive social context overall.

  10. Physical restraint in a therapeutic setting; a necessary evil?

    Science.gov (United States)

    Perkins, Elizabeth; Prosser, Helen; Riley, David; Whittington, Richard

    2012-01-01

    Physical restraint of people experiencing mental health problems is a coercive and traumatic procedure which is only legally permitted if it is proportionate to the risk presented. This study sought to examine the decision-making processes used by mental health staff involved in a series of restraint episodes in an acute care setting. Thirty nurses were interviewed either individually or in focus groups to elicit their views on restraint and experience in specific incidents. Four factors which influenced the decision to restrain were identified: contextual demands; lack of alternatives; the escalatory effects of restraint itself; and perceptions of risk. While some of these factors are amenable to change through improvements in practice, training and organisational culture, nurses viewed restraint as a necessary evil, justified on the basis of the unpredictable nature of mental illness and the environment in which they worked. Copyright © 2011 Elsevier Ltd. All rights reserved.

  11. Cyanine Conformational Restraint in the Far-Red Range.

    Science.gov (United States)

    Michie, Megan S; Götz, Ralph; Franke, Christian; Bowler, Matthew; Kumari, Nikita; Magidson, Valentin; Levitus, Marcia; Loncarek, Jadranka; Sauer, Markus; Schnermann, Martin J

    2017-09-13

    Far-red cyanine fluorophores find extensive use in modern microscopy despite modest quantum yields. To improve the photon output of these molecules, we report a synthetic strategy that blocks the major deactivation pathway: excited-state trans-to-cis polyene rotation. In the key transformation, a protected dialdehyde precursor undergoes a cascade reaction to install the requisite tetracyclic ring system. The resulting molecules exhibit the characteristic features of conformational restraint, including improved fluorescence quantum yield and extended lifetime. Moreover, these compounds recover from hydride reduction with dramatically improved efficiency. These observations enable efficient single-molecule localization microscopy in oxygenated buffer without addition of thiols. Enabled by modern organic synthesis, these studies provide a new class of far-red dyes with promising spectroscopic and chemical properties.

  12. Validity of the Child Facial Coding System for the Assessment of Acute Pain in Children With Cerebral Palsy.

    Science.gov (United States)

    Hadden, Kellie L; LeFort, Sandra; O'Brien, Michelle; Coyte, Peter C; Guerriere, Denise N

    2016-04-01

    The purpose of the current study was to examine the concurrent and discriminant validity of the Child Facial Coding System for children with cerebral palsy. Eighty-five children (mean = 8.35 years, SD = 4.72 years) were videotaped during a passive joint stretch with their physiotherapist and during 3 time segments: baseline, passive joint stretch, and recovery. Children's pain responses were rated from videotape using the Numerical Rating Scale and Child Facial Coding System. Results indicated that Child Facial Coding System scores during the passive joint stretch significantly correlated with Numerical Rating Scale scores (r = .72, P Child Facial Coding System scores were also significantly higher during the passive joint stretch than the baseline and recovery segments (P Child Facial Coding System is a valid method of identifying pain in children with cerebral palsy.

  13. Serotonin transporter in lymphocytes of rats exposed to physical restraint stress.

    Science.gov (United States)

    Medina-Martel, Matilde; Urbina, Mary; Fazzino, Fili; Lima, Lucimey

    2013-01-01

    Glucocorticoids and stress cause transcriptional and functional changes on the serotonin transporter (SERT) in the central nervous system. Stress can produce specific modifications of SERT in lymphocytes, which could be associated with alterations in immune response. The aim of this study was to evaluate the effect of a physical restraint stress protocol on (1) rat lymphocyte proliferation in the presence of the selective serotonin reuptake inhibitor fluoxetine and (2) SERT kinetic parameters, i.e. binding capacity (Bmax), affinity (Kd) and Hill coefficient (nH). Male adult Sprague-Dawley rats were placed in Plexiglass boxes (5 h daily for 5 days), and blood was obtained by cardiac puncture on day 6. Serum corticosterone was quantitated by an immunoenzymatic assay. Lymphocytes were isolated by density gradients and adhesion to plastic, of which there was sufficient material for further experiments, then cultured with or without the mitogen concanavalin A (Con A, 2 μg/ml) and fluoxetine (1-50 μM). Cell proliferation was measured with tetrazolium salts, and [(3)H]paroxetine was used as a SERT-specific ligand for binding assays. Restraint produced a significant increase in serum corticosterone of stressed rats. The proliferative response to Con A was similar in the controls and stressed animals. Fluoxetine reduced cell proliferation with and without Con A. Restraint diminished the inhibitory effect of fluoxetine on proliferation. Restraint also increased Bmax and Kd, but decreased nH. Treatment of rats with actinomycin D, a transcription inhibitor, reduced Bmax in stressed animals. Restraint stress modulated the effect of fluoxetine on cell proliferation, probably through the modification of the presence and the function of SERT. Copyright © 2013 S. Karger AG, Basel.

  14. The what, when, and why of implementation frameworks for evidence-based practices in child welfare and child mental health service systems.

    Science.gov (United States)

    Hanson, Rochelle F; Self-Brown, Shannon; Rostad, Whitney L; Jackson, Matthew C

    2016-03-01

    It is widely recognized that children in the child welfare system are particularly vulnerable to the adverse health and mental effects associated with exposure to abuse and neglect, making it imperative to have broad-based availability of evidence-based practices (EBPs) that can prevent child maltreatment and reduce the negative mental health outcomes for youth who are victims. A variety of EBPs exist for reducing child maltreatment risk and addressing the associated negative mental health outcomes, but the reach of these practices is limited. An emerging literature documents factors that can enhance or inhibit the success of EBP implementation in community service agencies, including how the selection of a theory-driven conceptual framework, or model, might facilitate implementation planning by providing guidance for best practices during implementation phases. However, limited research is available to guide decision makers in the selection of implementation frameworks that can boost implementation success for EBPs that focus on preventing child welfare recidivism and serving the mental health needs of maltreated youth. The aims of this conceptual paper are to (1) provide an overview of existing implementation frameworks, beginning with a discussion of definitional issues and the selection criteria for frameworks included in the review; and (2) offer recommendations for practice and policy as applicable for professionals and systems serving victims of child maltreatment and their families.

  15. Determinants of performance of health systems concerning maternal and child health: a global approach.

    Science.gov (United States)

    Pinzón-Flórez, Carlos Eduardo; Fernández-Niño, Julián Alfredo; Ruiz-Rodríguez, Myriam; Idrovo, Álvaro J; Arredondo López, Abel Armando

    2015-01-01

    To assess the association of social determinants on the performance of health systems around the world. A transnational ecological study was conducted with an observation level focused on the country. In order to research on the strength of the association between the annual maternal and child mortality in 154 countries and social determinants: corruption, democratization, income inequality and cultural fragmentation, we used a mixed linear regression model for repeated measures with random intercepts and a conglomerate-based geographical analysis, between 2000 and 2010. Health determinants with a significant association on child mortality(corrupt government (Q3 vs Q1 = 83,05; 95%CI: 33,10 to 133). Improving access to water and sanitation systems, decreasing corruption in the health sector must become priorities in health systems. The ethno-linguistic cultural fragmentation and the detriment of democracy turn out to be two factors related to health results.

  16. Keeping our children safe in motor vehicles: knowledge, attitudes and practice among parents in Kuwait regarding child car safety.

    Science.gov (United States)

    Raman, Sudha R; Landry, Michel D; Ottensmeyer, C Andrea; Jacob, Susan; Hamdan, Elham; Bouhaimed, Manal

    2013-01-01

    Child safety restraints can reduce risk of death and decrease injury severity from road traffic crashes; however, knowledge about restraints and their use in Kuwait is limited. A cross-sectional, self-administered survey about child car safety was used among a convenience sample of parents of children aged 18 years or younger at five Kuwaiti university campuses. Of 552 respondents, over 44% have seated a child in the front seat and 41.5% have seated a child in their lap while driving. Few parents are aware of and fewer report using the appropriate child restraint; e.g., 36% of parents of infants recognised an infant seat and 26% reported using one. Over 70% reported wearing seat belts either "all of the time" (33%) or "most of the time" (41%). This new information about parents' knowledge and practice regarding child car seat use in Kuwait can inform interventions to prevent child occupant injury and death.

  17. Psychiatric Nurses' Attitude and Practice toward Physical Restraint.

    Science.gov (United States)

    Mahmoud, Amal Sobhy

    2017-02-01

    This study was to assess psychiatric nurses' attitude and practice toward physical restraint among mentally ill patients. A descriptive research design was used to achieve the study objective. The present study was carried out in three specialized governmental mental hospitals and two psychiatric wards in general hospital. A convenient purposive sample of 96 nurses who were working in the previously mentioned setting was included. The tool used for data collection was the Self-Administered Structured Questionnaire; it included three parts: The first comprised items concerned with demographic characteristics of the nurses, the second comprised 10 item measuring nurses' attitudes toward physical restraint, and the third was used to assess nurses' practices regarding use of physical restraint. There were insignificant differences between attitudes and practices in relation to nurses' sex, level of education, years of experience and work place. Moreover, a positive significant correlation was found between nurses' total attitude scores, and practices regarding use of physical restraint. Psychiatric nurses have positive attitude and adequate practice toward using physical restraints as an alternative management for psychiatric patients. It is important for psychiatric nurses to acknowledge that physical restraints should be implemented as the last resort. The study recommended that it is important for psychiatric nurses to acknowledge that physical restraints should be implemented as the last resort. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Physical restraint in the ICU: does it prevent device removal?

    Science.gov (United States)

    Perren, A; Corbella, D; Iapichino, E; Di Bernardo, V; Leonardi, A; Di Nicolantonio, R; Buschbeck, C; Boegli, L; Pagnamenta, A; Malacrida, R

    2015-10-01

    Physical restraint is frequently used in the intensive care setting but little is known regarding its clinical scenario and effectiveness in preventing adverse events (AEs), defined as device removal. We carried out a prospective observational study in three Intensive Care Units on 120 adult high-risk patients. The effectiveness of physical restraint was evaluated using the propensity score methodology in order to obtain comparable groups. Physical restraint was applied in 1371 of 3256 (43%) nurse shifts accounting for 120 patients. Substantial agitation, the nurse's judgement of insufficient sedation and sedative drug reduction were positively associated with physical restraint, whereas the presence of analgesics at admission, increased disease gravity and the treating hospital as the most substantial variable showed a negative association. Eighty-six AEs were observed in 44 patients. Quiet (SAS=1-4), unrestrained patients accounted for 40 cases, and agitated (SAS≥5) but physically restrained patients for 17 cases. The presence of any type of physical restraint had a protective effect against any type of AE (OR=0.28; CI 0.16-0.51). The observed AEs showed a limited impact on the patients' course of illness. No physical harm related to physical restraint was reported. Physical restraint efficiently averts AEs. Its application is mainly driven by local habits. Typically, the almost recovered, apparently calm and hence unrestrained patient is at greatest risk for undesirable device removal. The control/interpretation of the patient's analgo-sedation might be inappropriate.

  19. "It's about Us": Marital Adjustment and Marital Adaptation in Couples Who Adopt Children from the Child Welfare System

    Science.gov (United States)

    Mooradian, John K.; Timm, Tina M.; Hock, Robert M.; Jackson, Rosemary

    2011-01-01

    This article examines, using grounded theory methodology, the marital relationships of couples who adopted children from the child welfare system. Twenty-two spouses in four focus groups reported initial marital adjustment that featured husbands' support of their wives' initiation of adoption and management of child needs. About one half of these…

  20. "It's about Us": Marital Adjustment and Marital Adaptation in Couples Who Adopt Children from the Child Welfare System

    Science.gov (United States)

    Mooradian, John K.; Timm, Tina M.; Hock, Robert M.; Jackson, Rosemary

    2011-01-01

    This article examines, using grounded theory methodology, the marital relationships of couples who adopted children from the child welfare system. Twenty-two spouses in four focus groups reported initial marital adjustment that featured husbands' support of their wives' initiation of adoption and management of child needs. About one half of these…

  1. Physical Restraint of People with Intellectual Disability: A Review of Implementation Reduction and Elimination Procedures

    Science.gov (United States)

    Luiselli, James K.

    2009-01-01

    Background: This review describes procedures to reduce and eliminate physical restraint of people with intellectual disability. One approach is to assess antecedent conditions associated with restraint and change them so that they no longer produce restraint-provoking behaviour. A second approach is to decrease the duration of restraint by…

  2. Child-Sized Gaps in the System: Case Studies of Child Suicidality and Support within the Australian Healthcare System

    Science.gov (United States)

    McKay, Kathy; Shand, Fiona

    2016-01-01

    While children both understand the concept of, and have died by, suicide, little research has been conducted on children's experiences of healthcare systems during and after a suicidal crisis. This article focuses on three case studies of mothers with suicidal daughters and aims to describe the health service experiences of parents whose children…

  3. Making It Work Without a Family Drug Court: Connecticut's Approach to Parental Substance Abuse in the Child Welfare System.

    Science.gov (United States)

    Ungemack, Jane; Giovannucci, Marilou; Moy, Samuel; Ohrenberger, Karen; Dematteo, Thomas; Smith, Staceyann

    2015-01-01

    Parental substance abuse presents, complex challenges for the child welfare system and courts. This article describes the State of Connecticut's experience implementing the Recovery Specialist Voluntary Program (RSVP), a recovery support program designed to confront the problem of parental substance abuse within the child welfare system without, a family drug court. The state-level collaboration efforts, system changes, factors affecting development and implementation of RSVP, program participants, and preliminary outcomes are described.

  4. Determinants of Performance of Health Systems Concerning Maternal and Child Health: A Global Approach

    OpenAIRE

    2015-01-01

    Aims To assess the association of social determinants on the performance of health systems around the world. Methods A transnational ecological study was conducted with an observation level focused on the country. In order to research on the strength of the association between the annual maternal and child mortality in 154 countries and social determinants: corruption, democratization, income inequality and cultural fragmentation, we used a mixed linear regression model for repeated measures ...

  5. ALTERNATION OF STANDPOINT (ATTITUDE ) IN EDUCATION SYSTEM TOWARDS A CHILD WITH SPECIAL NEEDS

    OpenAIRE

    Virbalienė, Rita

    2015-01-01

    The article represents alternation of standpoint (attitude) in reformed education system towards a child with special needs. In the theory and practice of integrated education so far is paid relatively low attention towards improvement of social interaction between disabled scholars and teachers, analysis and elimination of the reasons of prejudices, alternation of positive attitude. Very relevant issue in Lithuania, as well as throughout Europe, is slow alternation of attitude towards integr...

  6. Noma management in a child with systemic lupus erythematosus

    Directory of Open Access Journals (Sweden)

    Irna Sufiawati

    2010-03-01

    Full Text Available Background: Noma, also known as cancrum oris, is an orofacial gangrene, which during its fulminating stage causes progressive and mutilating destruction of the infected tissues. The disease occurs mainly in children with malnutrition, poor oral hygiene and debilitating concurrent illness. Purpose: The aim of this paper was to report a unique case of noma associated with systemic lupus erythematosus in an 8-year-old boy. Case: An 8-year-old boy referred to Oral Medicine Department complaining about an ulcer at the left corner of his mouth for 1 month, painful and difficulty in opening the mouth. The patient was diagnosed systemic lupus erythematosus since 14 months before and had been given immunosuppressive therapy. The patient was also diagnosed severe malnutrition. Haematologic investigations revealed anemia. Case management: Panoramic radiography was performed to check for dental or periodontal foci of infection, but no abnormalities were present. The microbiology examination revelaed Fusobacterium necrophorum, Staphylococcus aureus, and Klabsiella. The patient has been treated with oral irrigation using hydrogen peroxide, saline and 0.2% chlorhexidine, thus helped to slough the necrotic tissue. Oral antibiotics and analgesics were prescribed. The patient was admitted to hospital under the care of a pediatrician, allergy and immunology specialist, and a nutritionist. The result of the comprehensive disease management showed that the lesion healed completely, but leaving a scar on his corner of the mouth. Its physical effects are permanent and may require reconstructive surgery to be repaired by oral surgeon. Conclusion: Noma is not a primary disease, there are various predisposing factors usually precede its occurrence. The management of noma requires a multidisciplinary approach.Latar Belakang: Noma, dikenal sebagai cancrum oris, adalah gangren pada daerah orofasial, yang menyebabkan kerusakan progresif dari jaringan yang terinfeksi

  7. La vivencia de la sujeción mecánica experimentada por el personal de enfermería de una unidad de psiquiatria infanto-juvenil Mechanical restraints as experienced by nursing staff at a child and adolescent psychiatric unit

    Directory of Open Access Journals (Sweden)

    Susana Marqués Andrés

    2007-11-01

    Full Text Available Introducción: La sujeción mecánica es una técnica ampliamente utilizada por las enfermeras en los hospitales bajo indicación médica. Su utilización en las unidades de adolescentes provoca situaciones de conflicto emocional e inconvenientes viviéndolo las enfermeras en primera persona. Hablar de sujeción es poco concreto; para entenderla es necesario explicar motivos, situaciones, expectativas profesionales, tipo de enfermos y problemáticas. Los menores que ingresan en una unidad psiquiátrica sienten gran frustración, manifestándola habitualmente a través de agresividad al darse cuenta que pasarán algunos días ingresados. Objetivo: Conocer la vivencia del equipo de enfermería de la unidad de psiquiatría infanto juvenil del Hospital de Basurto (Bilbao, respecto al fenómeno de la sujeción mecánica de adolescentes. Método: El enfoque teórico es la fenomenología. El diseño, descriptivo interpretativo, basado en metodología cualitativa. Resultados: Las categorías emergidas durante el estudio se agrupan en tres, cada una con varias subcategorías: (a La intervención: la sujeción mecánica = las sensaciones corporales, los pensamientos y las actuaciones. (b El cuestionamiento = la evaluación individual, la percepción del equipo, la autocrítica de la utilización, el uso de los criterios. (c La utilidad de la técnica = la provocación del entorno, el refuerzo negativo, última alternativa. Existe un malestar generalizado como consecuencia de la utilización de la sujeción. Conclusiones: Unificar criterios es necesario para trabajar de manera cohesionada, tranquila y autocontrolada siendo la autocrítica una necesidad útil para emplear una técnica tan conflictiva y compleja de usar como real en su aplicación.Introduction: The restraint is a technique widely used by nurses in hospitals under medical supervision. Its use in psychiatric units adolescent patients can result in emotionally conflictive. When referring to the

  8. [Nursing care of a school-age child with asthma: an ecological system theory approach].

    Science.gov (United States)

    Tzeng, Yu-Fen; Gau, Bih-Shya

    2012-02-01

    This research applied the Ecological System Theory of Dr. Bronfenbrenner (1979) to evaluate and analyze the impact of a school-age asthmatic child's ecological environment on the child's development. This project ran from March 16th to April 16th, 2010. A full range of data was collected during clinical care, outpatient follow-up services, telephone interviews, home visits, and school visits and then identified and analyzed. Results indicated that the family, household environment, campus, teachers, classmates, physical education program, and medical staffs comprised the most immediate microsystem and that parents, school nurses, teachers, and classmates formed the child's mesosystem. Researchers found a lack of understanding and appreciation in the mesosystem regarding asthmatic patient care needs. Hidden factors in the environment induced asthma, which eventually caused the child to be unable to obtain necessary medical care assistance. The exosystem reflected adequacy of the family social economy. The father's flexible working hours allowed him to allocate more time to childcare responsibilities. The government Asthma Medical Payment program also facilitated effective care. The macrosystem demonstrated parental cognition related to asthma treatment and caring to be deeply influenced by local customs. Thus, rather than using advanced medical treatments, parents preferred to follow traditional Chinese medicinal practices. Evaluation using the Ecological of Human Development Theory showed the subject's ecology environment relationships as based upon a foundation of family and school. Therefore, active family and school support for an asthma management plan appropriate to the subject's needs was critical. Asthma symptoms were better controlled after the child and his parents invested greater effort in mastering asthma management protocols.

  9. Estimation of the level of cognitive development of a preschool child using the system of situations

    Directory of Open Access Journals (Sweden)

    Pavel Gorev

    2016-02-01

    Full Text Available The article describes a model of reliable estimation of cognitive development of a preschool child by means of the system of situations. Thus the leading technology is modeling the systems of open-type tasks of mathematical contents and the system analysis of big selections of experimental data based on the two-point scale of four parameters: optimality of the ideas offered by children; efficiency of the reasoning given by them; originality of their answer and level of decision development. As a result of the pilot study conducted in 2015 on selection of 3,800 preschool children, it was succeeded to approve the offered technology of estimation and to generalize results in the form of the integrated assessment of relative character – coefficient of cognitive development level. Mathematical-statistical processing of the results of the research allows to prove uniformity of experimental selection and to specify the level of cognitive development with a reliable accuracy of normal distribution for each age group of the preschool child basing on calculation of samples quartiles that in turn can define the further program of individual development of a child providing his transition to higher level of the general education and consequently, higher quality of education.

  10. Self-restraint as positive reinforcement for self-injurious behavior.

    Science.gov (United States)

    Smith, R G; Lerman, D C; Iwata, B A

    1996-01-01

    Many individuals who engage in self-injurious behavior (SIB) also exhibit self-restraint. We compared rates of SIB exhibited by a 32-year-old woman diagnosed with profound retardation across conditions in which access to restraint was (a) continuously available, (b) presented as a consequence for SIB, or (c) unavailable. Rates of SIB increased when access to restraint was contingent upon SIB and decreased when restraint was unavailable, suggesting that self-restraint functioned as positive reinforcement for SIB.

  11. The design, fabrication and delivery of a manipulator foot restraint mockup for space telescope development testing

    Science.gov (United States)

    Hollingsworth, M. A.

    1986-01-01

    The Manipulator Foot Restraint (MFR) is a subsystem of the Remote Manipulator System (RMS) which plays a major role in servicing the Hubble Space Telescope (HST) in orbit. Flight drawings were used to construct the MFR to guarantee that the mockup components were functionally equivalent to the flight MFR. Material surface finishes and tolerances that were compatible to the Neutral Buoyance Simulator (NBS) environment were used. Recommendation for improvements are discussed.

  12. Predictors of physical restraint in a psychiatric emergency setting

    National Research Council Canada - National Science Library

    Hadi, Fatemeh; Khosravi, Termeh; Shariat, Seyed Vahid; Jalali Nadoushan, Amir Hossein

    2015-01-01

    Considering the negative consequences of using physical restraints, we conducted this study to identify patients who are more frequently restrained in a psychiatric emergency ward as an initial step...

  13. Pilot Hartsfield in sleep restraint tethered to forward middeck lockers

    Science.gov (United States)

    1982-01-01

    Pilot Hartsfield demonstrates the sleeping accomodations onboard the Earth-orbiting Columbia, Orbiter Vehicle (OV) 102. The sleep restraint is located in the middeck area of the spacecraft and is tethered to forward middeck lockers.

  14. Dietary restraint and self-regulation in eating behavior

    National Research Council Canada - National Science Library

    Johnson, F; Pratt, M; Wardle, J

    2012-01-01

    .... This review discusses evidence from the dietary restraint literature and from studies of self-regulation processes to examine how far self-imposed control around food can be seen as beneficial...

  15. Molecular dynamics simulations with replica-averaged structural restraints generate structural ensembles according to the maximum entropy principle.

    Science.gov (United States)

    Cavalli, Andrea; Camilloni, Carlo; Vendruscolo, Michele

    2013-03-07

    In order to characterise the dynamics of proteins, a well-established method is to incorporate experimental parameters as replica-averaged structural restraints into molecular dynamics simulations. Here, we justify this approach in the case of interproton distance information provided by nuclear Overhauser effects by showing that it generates ensembles of conformations according to the maximum entropy principle. These results indicate that the use of replica-averaged structural restraints in molecular dynamics simulations, given a force field and a set of experimental data, can provide an accurate approximation of the unknown Boltzmann distribution of a system.

  16. Specific 13C labeling of leucine, valine and isoleucine methyl groups for unambiguous detection of long-range restraints in protein solid-state NMR studies.

    Science.gov (United States)

    Fasshuber, Hannes Klaus; Demers, Jean-Philippe; Chevelkov, Veniamin; Giller, Karin; Becker, Stefan; Lange, Adam

    2015-03-01

    Here we present an isotopic labeling strategy to easily obtain unambiguous long-range distance restraints in protein solid-state NMR studies. The method is based on the inclusion of two biosynthetic precursors in the bacterial growth medium, α-ketoisovalerate and α-ketobutyrate, leading to the production of leucine, valine and isoleucine residues that are exclusively (13)C labeled on methyl groups. The resulting spectral simplification facilitates the collection of distance restraints, the verification of carbon chemical shift assignments and the measurement of methyl group dynamics. This approach is demonstrated on the type-three secretion system needle of Shigella flexneri, where 49 methyl-methyl and methyl-nitrogen distance restraints including 10 unambiguous long-range distance restraints could be collected. By combining this labeling scheme with ultra-fast MAS and proton detection, the assignment of methyl proton chemical shifts was achieved.

  17. Specific 13C labeling of leucine, valine and isoleucine methyl groups for unambiguous detection of long-range restraints in protein solid-state NMR studies

    Science.gov (United States)

    Fasshuber, Hannes Klaus; Demers, Jean-Philippe; Chevelkov, Veniamin; Giller, Karin; Becker, Stefan; Lange, Adam

    2015-03-01

    Here we present an isotopic labeling strategy to easily obtain unambiguous long-range distance restraints in protein solid-state NMR studies. The method is based on the inclusion of two biosynthetic precursors in the bacterial growth medium, α-ketoisovalerate and α-ketobutyrate, leading to the production of leucine, valine and isoleucine residues that are exclusively 13C labeled on methyl groups. The resulting spectral simplification facilitates the collection of distance restraints, the verification of carbon chemical shift assignments and the measurement of methyl group dynamics. This approach is demonstrated on the type-three secretion system needle of Shigella flexneri, where 49 methyl-methyl and methyl-nitrogen distance restraints including 10 unambiguous long-range distance restraints could be collected. By combining this labeling scheme with ultra-fast MAS and proton detection, the assignment of methyl proton chemical shifts was achieved.

  18. Testing a theory of organizational culture, climate and youth outcomes in child welfare systems: a United States national study.

    Science.gov (United States)

    Williams, Nathaniel J; Glisson, Charles

    2014-04-01

    Theories of organizational culture and climate (OCC) applied to child welfare systems hypothesize that strategic dimensions of organizational culture influence organizational climate and that OCC explains system variance in youth outcomes. This study provides the first structural test of the direct and indirect effects of culture and climate on youth outcomes in a national sample of child welfare systems and isolates specific culture and climate dimensions most associated with youth outcomes. The study applies multilevel path analysis (ML-PA) to a U.S. nationwide sample of 2,380 youth in 73 child welfare systems participating in the second National Survey of Child and Adolescent Well-being. Youths were selected in a national, two-stage, stratified random sample design. Youths' psychosocial functioning was assessed by caregivers' responses to the Child Behavior Checklist at intake and at 18-month follow-up. OCC was assessed by front-line caseworkers' (N=1,740) aggregated responses to the Organizational Social Context measure. Comparison of the a priori and subsequent trimmed models confirmed a reduced model that excluded rigid organizational culture and explained 70% of the system variance in youth outcomes. Controlling for youth- and system-level covariates, systems with more proficient and less resistant organizational cultures exhibited more functional, more engaged, and less stressful climates. Systems with more proficient cultures and more engaged, more functional, and more stressful climates exhibited superior youth outcomes. Findings suggest child welfare administrators can support service effectiveness with interventions that improve specific dimensions of culture and climate.

  19. Physical restraint use and older patients' length of hospital stay.

    Science.gov (United States)

    Bai, Xue; Kwok, Timothy C Y; Ip, Isaac N; Woo, Jean; Chui, Maria Y P; Ho, Florence K Y

    2014-01-01

    In both acute care and residential care settings, physical restraints are frequently used in the management of patients, older people in particular. Recently, the negative outcomes of physical restraint use have often been reported, but very limited research effort has been made to examine whether such nursing practice have any adverse effects on patients' length of stay (LOS) in hospitals. The aim of this study was to examine the association between physical restraint use on older patients during hospitalization and their LOS. Medical records of 910 older patients aged 60 years and above admitted to one of the Hong Kong public hospitals in 2007 were randomly selected and recorded during July to September 2011. The recorded items included patients' general health status, physical and cognitive function, the use of physical restraints, and patients' LOS. Hierarchical regression analysis was conducted to analyze the data. The results indicated that older patients' general health status, physical, and cognitive function were important factors affecting their LOS. Independent of these factors, the physical restraint use was still significantly predictive of longer LOS, and these two blocks of variables together served as an effective model in predicting older patients' LOS in the hospital. Since physical restraint use has been found to be predictive of longer hospital stay, physical restraints should be used with more caution and the use of it should be reduced on older patients in the hospital caring setting. All relevant health care staff should be aware of the negative effects of physical restraint use and should reduce the use of it in hospital caring and nursing home settings.

  20. School absence and treatment in school children with respiratory symptoms in the Netherlands: Data from the Child Health Monitoring System

    NARCIS (Netherlands)

    Spee-van Der Wekke, J.; Meulmeester, J.F.; Radder, J.J.; Verloove-Vanhorick, S.P.

    1998-01-01

    Study objective - To assess the prevalence of respiratory problems, and the relation of these problems with school attendance, medicine use, and medical treatment. Design - The Child Health Monitoring System. Setting - Nineteen public health services across the Netherlands. Participants - 5186

  1. Suspension restraint - Induced hypokinesia and antiorthostasis as a simulation of weightlessness

    Science.gov (United States)

    Musacchia, X. J.; Steffen, J. M.; Deavers, D. R.

    1982-01-01

    Muscle, renal, fluid and electrolyte responses were measured in suspended rats; the hind limbs are non-load bearing and the front limbs can be used for feeding and grooming. Hind limb hypokinesia reverses after removal from the suspension harness. This suspension system is adjustable for a head-down tilt to produce antiorthostatic responses which are also reversible. Responses to hypokinesia or antiorthostatic hypokinesia for up to 14 days were measured, e.g., muscle atrophy: soleus greater than gastrocnemius equals plantaris greater than extensor digitorum longus, kaliuresis, and increased excretion of urea, NH3, and 3 methylhistidine. Muscle protein loss, a response to a reduction in RNA, is also reversible. A head-down tilt for 7-14 days results in diuresis and natriuresis. These changes are reversed within 24 hours after removal from the restraint harness. Physiological effects of suspension restraint can be used to simulate and predict responses to microgravity exposure.

  2. Special health care needs among children in the child welfare system.

    Science.gov (United States)

    Ringeisen, Heather; Casanueva, Cecilia; Urato, Mathew; Cross, Theodore

    2008-07-01

    The aim of this study was to determine levels of special health care need among children in the child welfare system and how these needs may affect children's functioning. Data were from the National Survey of Child and Adolescent Well-being, a national probability study of children investigated for child maltreatment. The sample consisted of 5496 children aged 0 to 15 years at baseline. For analysis, we used descriptive statistics to determine special health care needs and children's functioning from baseline to 3-year follow-up. Logistic regression was used to examine correlates of special health care needs. At any point in the study period, approximately one third of the children were identified as having special health care needs. Overall, across 3 years of follow-up data, 50.3% of the children were identified as having special health care needs. Boys were significantly more likely than girls to have had special health care needs, and children aged 0 to 2 years at baseline were significantly less likely to have had special health care needs than older children. Adopted and foster children were significantly more likely to have had special health care needs than children never placed out of the home. The most commonly reported type of chronic health condition was asthma. The most commonly reported type of special need was a learning disability. Special health care needs are prevalent among children in the child welfare system. Many children with special health care needs have cognitive, language, adaptive, social, or behavioral functional impairments. Mechanisms are needed to ensure that this vulnerable population has access to and receives coordinated health and related social services.

  3. Anticipatory precrash restraint sensor feasibility study: Final report

    Energy Technology Data Exchange (ETDEWEB)

    Kercel, S.W.; Dress, W.B.

    1995-08-01

    This report explores feasibility of an anticipatory precrash restraint sensor. The foundation principle is the anticipation mechanism found at a primitive level of biological intelligence and originally formalized by the mathematical biologist Robert Rosen. A system based on formal anticipatory principles should significantly outperform conventional technologies. It offers the prospect of high payoff in prevention of death and injury. Sensors and processes are available to provide a good, fast, and inexpensive description of the present dynamical state of the vehicle to the embedded system model in the anticipation engine. The experimental part of this study found that inexpensive radar in a real-world setting does return useful data on target dynamics. The data produced by a radar system can be converted to target dynamical information by good, fast and inexpensive signal-processing techniques. Not only is the anticipatory sensor feasible, but further development under the sponsorship of the National Highway Traffic Safety Administration is necessary and desirable. There are a number of possible lines of follow-on investigation. The level of effort and expected benefits of various alternatives are discussed.

  4. Psychiatric patients' perception of physical restraint.

    Science.gov (United States)

    Fugger, G; Gleiss, A; Baldinger, P; Strnad, A; Kasper, S; Frey, R

    2016-03-01

    To investigate psychiatric patients' subjective perception during and after belt fixation. All patients who were involuntarily admitted and physically restrained at a psychiatric intensive care unit within an 18-month study period were analysed. Ratings were obtained at four visits when questioning was possible. Within a heterogeneous diagnostic sample of 47 patients, only 12 patients were eligible to participate during belt fixation. After cessation of fixation, eight patients lacked any memory of restraint, while 36 could be questioned. Visual analogue scale median scores indicated powerlessness and depressiveness rather than anxiety and aggression. Patients' acceptance of the coercive measure was significantly higher (P = 0.003), while patients' memory was significantly lower than expected (P < 0.001). About 50% of the patients documented high perceived coercion, and post-traumatic stress disorder (PTSD) could be supposed in a quarter of the restrained individuals. Subjective perceptions concerning fixation showed no significant changes over time. Results showed high interindividual variability. Visual analogue scale revealed that belt fixation seemed to be forgotten or accepted in the majority of patients, probably due to psychiatric intensive care, psychopharmacological treatment and clinical improvements. The responses of a quarter of the patients assessed before discharge may be in accordance with symptoms of PTSD. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  5. Food craving, dietary restraint and mood.

    Science.gov (United States)

    Hill, A J; Weaver, C F; Blundell, J E

    1991-12-01

    A common assumption is that dieting causes food cravings, probably as a result of food energy deprivation. This issue was investigated in a two-phase study. In phase one, 206 women completed the Dutch Eating Behaviour Questionnaire, the Three-Factor Eating Questionnaire and a food craving scale. A correlational analysis showed food craving to be only weakly related to dietary restraint, but highly and significantly correlated with external eating, emotional eating and susceptibility to hunger. In phase two, ten women who regularly experienced food cravings and ten who rarely craved food kept prospective records of their food intake, daily mood and food craving episodes. There were few differences in eating behaviour, although the cravers tended to consume slightly more daily energy than the non-cravers. The cravers had higher ratings of boredom and anxiety during the day, and dysphoric mood was prominent prior to the cravings themselves. Food deprivation does not appear to be a necessary condition for food cravings to occur. Rather, food cravings are closely associated with mood, in particular as an antecedent to craving and also as a consequence of craving.

  6. The magnitude of injury problems among child labourers in a rural community of Bangladesh: findings from an injury surveillance system.

    Science.gov (United States)

    Dalal, Koustuv; Rahman, Fazlur; Gifford, Mervyn; Rahman, Aminur

    2016-01-01

    Child labour is an important topic in contemporary society. In this study we have tried to explore the magnitude of injury problems among child labourers in Bangladesh using an injury surveillance system. An injury surveillance system (ISS) was performed under the Prevention of Child Injuries through Social intervention and Education (PRECISE) project in Bangladesh during 2006-2010 in three sub-districts covering a population of more than 700,000. We used the ISS for assessing child labour. Appropriate epidemiological methods were considered in the study. Considering the reported main occupation of the children, 30% of children from the surveillance households were identified as child labourers. More than two thirds of child labourers were educated to primary or secondary level. The majority of boys worked as unskilled labourers and girls were employed in domestic work. The incidence of injury and deaths among child labourers was estimated as 24 per 100,000 children years. More than 19 injury related illnesses of moderate to severe intensity were found among 1000 child labourers in a year. Fractures, sprains, dislocations, cuts/wounds, animal bites, abrasions or lacerations, burns, head injuries and internal organ injuries are most common among child labourers. Working children are at risk of injury, death and illness in Bangladesh. Child labourers are now even more clearly tied to quantified morbidity and mortality. © The Author 2015. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  7. REUNIFICATION OF CHILDREN FROM INSTITUTIONS TO BIRTH FAMILY WITHIN THE CONTEXT OF ACTUAL CHANGES IN CHILD PROTECTION SYSTEM

    Directory of Open Access Journals (Sweden)

    Sychrová Adriana

    2013-12-01

    Full Text Available The purpose of the article discusses reunification of children from institutional care to their birth families within the context of actual transformation of child protection system. Reunification is the process of reintegration of vulnerable child placed „out of home“to his or her family, if it is the best interest of the child. Reunification of children placed in institutions should be a primary goal of the system because of a preference for the role of parents in the law, especially in the Convention on the Rights of the Child. The article is based on the analysis of documents of international organizations dealing with the protection of children's rights, international studies and program policy documents. The topic of reunification can be viewed from different perspectives, such as law and its influence on social policy and the practices of social work, the part of deinstitutionalization process or the decision making process. The main question is about interest of parents to care for their child. Social workers have to know characteristic of the family and the child. Then the reunification can start effectively. The family, child, specialists from institutions and social workers should participate on the process in more detail. In the conclusion of the paper the author tries to show principles and central values on which the successful process of reunification should be focused. She highlightes holistic view and complex assessment of family and safe family environment, the principle of partnership with family, the working with individual plan for child, the support of new family services, the performing sufficient preparation of the child, the family and the social environment before reuenification, intensive social services for family after returning home and finally the need for research on the process of reunification from the perspective of the child, parents and the professionals

  8. Data Surveillance in Child Protection Systems Development: An Indonesian Case Study

    Science.gov (United States)

    Boothby, Neil; Stark, Lindsay

    2011-01-01

    Objectives: Successful implementation of child protection program interventions and child and family welfare services is contingent upon the availability and use of good quality information, as emphasized by the recent Convention on the Rights of the Child's General Comment 13. Yet, the role of information within child protection is not well…

  9. Impact of Trauma System Preparedness on the Outcomes of Severe Child and Adolescent Injuries.

    Science.gov (United States)

    Afifi, Raouf

    2015-12-01

    Severe child trauma poses a heavy burden upon the public's health and the nations' economies, in terms of mortality, morbidity, and disability. The burden varies by the maturity level of the adopted trauma system. This work aimed to identify the impact of trauma system maturity upon the outcomes of care of severely injured children. Discharge data for hospitalized trauma children in Florida (mature trauma system) and Indiana (immature trauma system) were retrospectively analyzed. All severely injured children, 1-15 years of age with an injury severity score ≥25 during 1999-2000 were included. Assessment involved the differences in specified treatment procedures, survival rates, hospital length of stay, and the need for post-hospital institutional care. Analysis revealed that Indiana children significantly stay longer in hospital, and that no differences in the rates of patient mortality, discharge home, and selected procedures were found. Trauma system maturity impacts the volume and complexity of interventions, as well as the mortality, morbidity, and disability associated with the severe child and adolescent trauma. The cost of such burden could be directed to improving quality of the state's injury management services.

  10. The Design and Validation of a Child Developmental e-Screening System.

    Science.gov (United States)

    Cheng, Hsin-Yi Kathy; Chang, Hsien-Tsung; Huang, Po-Hsin; Ju, Yan-Ying; Chen, Li-Ying; Tseng, Kevin C

    2017-04-01

    An effective screening test could significantly impact identification of developmental delays at an early age. However, many studies have shown that delay screenings still use text-based screening survey questionnaires. Unfortunately, the traditional text-based screening method tends to be fairly passive. In addition, the advantages of using an interactive system and animation have been shown to lead to positive effects on learning in medical research. Therefore, a multimedia screening system is necessary. This study constructs a system architecture to develop an e-screening system for child developmental delays. To validate the system after development, this study conducted an experiment and employed a questionnaire to survey users. Five experts and 120 subjects participated in the experiment. After the experiment, the results of the system evaluation revealed excellent agreement between the text-based and multimedia version of Taipei II. A total of 118 (98%) participants preferred the multimedia version or had no preference, and only 2 (2%) preferred the paper version. Regular text-based screening sometimes excludes those with low literacy and those whose native language is different from the text. In addition, text-based screening tools lose users' attention easily. The current study successfully developed a multimedia text-based screening system. Feedback from the participants showed that the e-screening system was well accepted and more easily accessible than the original. In this study, a child developmental delays e-screening system was developed. After the experiment, the subjects indicated that the developmental delay e-screening system increased their comprehension and kept them interested in the screening.

  11. Sarcandra glabra Extract Reduces the Susceptibility and Severity of Influenza in Restraint-Stressed Mice

    Directory of Open Access Journals (Sweden)

    Hui-Juan Cao

    2012-01-01

    Full Text Available Sarcandra glabra, as a type of “antipyretic-detoxicate drugs”, has always been widely used in traditional Chinese medicine (TCM. The Sarcandra glabra extract (SGE is applied frequently as anti-inflammatory and anti-infectious drug in folk medicine. However, relative experiment data supporting this effective clinical consequence was limited. In order to mimic the physiological conditions of the susceptible population, we employed restraint stress mouse model to investigate the effect of SGE against influenza. Mice were infected with influenza virus three days after restraint, while SGE was orally administrated for 10 consecutive days. Body weight, morbidity, and mortality were recorded daily. Histopathologic changes, susceptibility genes expressions and inflammatory markers in lungs were determined. Our results showed that restraint stress significantly increased susceptibility and severity of influenza virus. However, oral administration of SGE could reduce morbidity, mortality and significantly prolonged survival time. The results further showed that SGE had a crucial effect on improving susceptibility markers levels to recover the balance of host defense system and inhibiting inflammatory cytokines levels through down-regulation of NF-κB protein expression to ameliorate the lung injury. These data showed that SGE reduced the susceptibility and severity of influenza.

  12. Domestic violence and immigration status among Latina mothers in the child welfare system: findings from the National Survey of Child and Adolescent Well-being II (NSCAW II).

    Science.gov (United States)

    Ogbonnaya, Ijeoma Nwabuzor; Finno-Velasquez, Megan; Kohl, Patricia L

    2015-01-01

    Many children involved with the child welfare system witness parental domestic violence. The association between children's domestic violence exposure and child welfare involvement may be influenced by certain socio-cultural factors; however, minimal research has examined this relationship. The current study compares domestic violence experiences and case outcomes among Latinas who are legal immigrants (n=39), unauthorized immigrants (n=77), naturalized citizens (n=30), and US-born citizen mothers (n=383) reported for child maltreatment. This analysis used data from the second round of the National Survey of Child and Adolescent Well-being. Mothers were asked about whether they experienced domestic violence during the past year. In addition, data were collected to assess if (a) domestic violence was the primary abuse type reported and, if so, (b) the maltreatment allegation was substantiated. Results show that naturalized citizens, legal residents, and unauthorized immigrants did not differ from US-born citizens in self-reports of domestic violence; approximately 33% of mothers reported experiences of domestic violence within the past year. Yet, unauthorized immigrants were 3.76 times more likely than US-born citizens to have cases with allegations of domestic violence as the primary abuse type. Despite higher rates of alleged domestic violence, unauthorized citizens were not more likely than US-born citizens to have these cases substantiated for domestic violence (F(2.26, 153.99)=0.709, p=.510). Findings highlight that domestic violence is not accurately accounted for in families with unauthorized immigrant mothers. We recommend child welfare workers are trained to properly assess and fulfill the needs of immigrant families, particularly as it relates to domestic violence.

  13. Assessing the Validity of the Qualistar Early Learning Quality Rating and Improvement System as a Tool for Improving Child-Care Quality

    Science.gov (United States)

    Zellman, Gail L.; Perlman, Michal; Le, Vi-Nhuan; Setodji, Claude Messan

    2008-01-01

    As a result of the generally low quality of child care in the United States and the increased emphasis on accountability in education policy, quality rating systems (QRSs) are proliferating in the child-care arena. QRSs assess child-care providers on multiple dimensions of quality and integrate these assessments into an easily understood summary…

  14. Necrotizing Polyarteritis Nodosa-like Vasculitis in a Child with Systemic Lupus Erythematosus.

    Science.gov (United States)

    Nada, Ritambhra; Matthews, Joseph L; Bhattad, Sagar; Gupta, Anju; Singh, Surjit

    2017-02-15

    A 10-year-old child presented with prolonged fever, lymphadenopathy, weight loss, oral ulcers, alopecia and parotitis. She later developed arterial thrombosis, poly-serositis, nephritis, myocarditis, sacro-ilitis, autoimmune hemolytic anemia and refractory thrombocytopenia. Though anti-dsDNA was negative, she was diagnosed to have systemic lupus erythematosus (SLE). Terminally, she had pulmonary symptoms and succumbed to her illness. The autopsy showed lupus nephritis-Class II, polyserositis, myocarditis, inflammatory myositis, immune mediated vasculitis involving renal, coronary, pancreatic, adrenal, dermal and intramuscular arteries, and pulmonary hemorrhages and edema.

  15. Child Disaster Mental Health Services: a Review of the System of Care, Assessment Approaches, and Evidence Base for Intervention.

    Science.gov (United States)

    Pfefferbaum, Betty; North, Carol S

    2016-01-01

    Several decades of research have informed our knowledge of children's reactions to disasters and the factors that influence their reactions. This article describes the system of care for child disaster mental health services using population risk to determine needed services and a stepped care approach built on assessment and monitoring to advance children to appropriate services. To assess the evidence base for disaster interventions, recent reviews of numerous child disaster mental health interventions are summarized.

  16. The Use of Physical Restraint in Norwegian Adult Psychiatric Hospitals.

    Science.gov (United States)

    Wynn, Rolf

    2015-01-01

    Background. The use of coercion within the psychiatric services is problematic and raises a range of ethical, legal, and clinical questions. "Physical restraint" is an emergency procedure used in psychiatric hospitals to control patients that pose an imminent physical danger. We wished to review the literature published in scientific peer-reviewed journals describing studies on the use of physical restraint in Norway, in order to identify the current state of knowledge and directions for future research. Design. The databases PubMed, PsycINFO, CINAHL, Web of Science, and Embase were searched for studies relating to physical restraint (including holding) in Norwegian psychiatric hospitals, supplemented with hand searches. Results. 28 studies were included. Most of the studies were on rates of restraint, but there were also some studies on perceptions of patients and staff, case studies, and ethnographic studies. There was only one intervention study. There are differences in use between wards and institutions, which in part may be explained by differences in patient populations. Staff appear to be less negative to the use of restraint than patients. Conclusions. The studies that were identified were primarily concerned with rates of use and with patients' and staff's perspectives. More interventional studies are needed to move the field forward.

  17. RESTRAINTS AND PATIENTS WITH MENTAL DISORDERS AND AGGRESSIVE BEHAVIOR

    Directory of Open Access Journals (Sweden)

    Zartaloudi A.

    2009-10-01

    Full Text Available BACKGROUND: Aggression management and means of control in psychiatric settings is an international issue. Many studies in mental health literature are related to the appearance and the causes of violence and the use of control procedures, such as seclusion and restraint, from mental health professionals in order to control and suppress aggressive and violent behavior. AIM: The purpose of this study is to present the restraints used to control the behaviour of mentally ill patients, the relationship between aggressive behavior and mental disorders and the historical background concerning the use of restrictive measures. METHOD: A critical review of this body of literature was carried out. Evidence was collected through Medline database. RESULTS: Two restraint techniques are used in order to cope with patients who could cause harm to themselves or their environment, physical restraint and seclusion. These restrictive measures are used through centuries in order to suppress violent behaviour of mental patients. CONCLUSION: Involuntary treatment and restraint are used when patients loose control of their behavior. In fact it is difficult to achieve a balance between ensuring patients’ rights and needs and preventing them from harming themselves or the others.

  18. Extraction of distance restraints from pure shift NOE experiments

    Science.gov (United States)

    Kaltschnee, Lukas; Knoll, Kevin; Schmidts, Volker; Adams, Ralph W.; Nilsson, Mathias; Morris, Gareth A.; Thiele, Christina M.

    2016-10-01

    NMR techniques incorporating pure shift methods to improve signal resolution have recently attracted much attention, owing to their potential use in studies of increasingly complex molecular systems. Extraction of frequencies from these simplified spectra enables easier structure determination, but only a few of the methods presented provide structural parameters derived from signal integral measurements. In particular, for quantification of the nuclear Overhauser effect (NOE) it is highly desirable to utilize pure shift techniques where signal overlap normally prevents accurate signal integration, to enable measurement of a larger number of interatomic distances. However, robust methods for the measurement of interatomic distances using the recently developed pure shift techniques have not been reported to date. In this work we discuss some of the factors determining the accuracy of measurements of signal integrals in interferogram-based Zangger-Sterk (ZS) pure shift NMR experiments. The ZS broadband homodecoupling technique is used in different experiments designed for quantitative NOE determination from pure shift spectra. It is shown that the techniques studied can be used for quantitative extraction of NOE-derived distance restraints, as exemplified for the test case of strychnine.

  19. Knowledge and practice of childhood motor vehicle restraint use in Nova Scotia: phase II.

    Science.gov (United States)

    Yanchar, Natalie L; Young, Julian B; Langille, Donald B

    2015-01-01

    To examine changes to knowledge and practice of childhood motor vehicle restraint (CMVR) use in Nova Scotia after the implementation of stricter car seat and new booster seat (BS) legislation in 2007. A random telephone survey of households (at least one child 3.0-68) and 43(17-114), respectively). With regards to rear-facing car seats (RFCSs), new legislation and associated social marketing on graduating from a rear-facing car seat was not associated with increases in correct practice. Legislation, combined with social marketing at the time of introduction, is an effective means to educate parents on when to graduate from a FFCS and the importance of BSs while also influencing parents to use them, though not for RFCS graduation. The known protective effect of BSs dictates the need for all regions in Canada to adopt comprehensive BS legislation. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. Moving science into state child and adolescent mental health systems: Illinois' evidence-informed practice initiative.

    Science.gov (United States)

    Starin, Amy C; Atkins, Marc S; Wehrmann, Kathryn C; Mehta, Tara; Hesson-McInnis, Matthew S; Marinez-Lora, A; Mehlinger, Renee

    2014-01-01

    In 2005, the Illinois State Mental Health Authority embarked on an initiative to close the gap between research and practice in the children's mental health system. A stakeholder advisory council developed a plan to advance evidence informed practice through policy and program initiatives. A multilevel approach was developed to achieve this objective, which included policy change, stakeholder education, and clinician training. This article focuses on the evidence-informed training process designed following review of implementation research. The training involved in-person didactic sessions and twice-monthly telephone supervision across 6 cohorts of community based clinicians, each receiving 12 months of training. Training content initially included cognitive behavioral therapy and behavioral parent training and was adapted over the years to a practice model based on common element concepts. Evaluation based on provider and parent report indicated children treated by training clinicians generally showed superior outcomes versus both a treatment-as-usual comparison group for Cohorts 1 to 4 and the statewide child population as a whole after 90 days of care for Cohorts 5 to 6. The results indicated primarily moderate to strong effects for the evidence-based training groups. Moving a large public statewide child mental health system toward more effective services is a complex and lengthy process. These results indicate training of community mental health providers in Illinois in evidence-informed practice was moderately successful in positively impacting child-level functional outcomes. These findings also influenced state policy in committing resources to continuing the initiative, even in difficult economic times.

  1. Interactions Between Policy Effects, Population Characteristics and the Tax-Benefit System: An Illustration Using Child Poverty and Child Related Policies in Romania and the Czech Republic.

    Science.gov (United States)

    Avram, Silvia; Militaru, Eva

    We investigate the impact of the Romanian and Czech family policy systems on the poverty risk of families with children. We focus on separating out the effects of policy design itself and size of benefits from the interaction between policies and population characteristics. We find that interactions between population characteristics, the wider tax benefit system and child related policies are pervasive and large. Both population characteristics and the wider tax-benefit environment can dramatically alter the antipoverty effect of a given set of policies.

  2. [Medical-legal issues of physical and pharmacological restraint].

    Science.gov (United States)

    Gómez-Durán, Esperanza L; Guija, Julio A; Ortega-Monasterio, Leopoldo

    2014-03-01

    The use of physical and pharmacological restraint is controversial but is currently accepted as inevitable. It is indicated for controlling behavioral disorders and psychomotor agitation that put patients and third parties at risk. Its indication should be medical, and we should opt for the least restrictive measure. Restraints represent a possible infringement of patients' fundamental rights and require understanding and strict respect for the medical-legal precepts by physicians and other practitioners involved in its application. This article reviews the current legal framework, as well as the medical-legal premises and aspects of applying restraints, with the objective of ensuring maximum respect for patients' rights and the appropriate legal safety in the activity of practitioners. Copyright © 2014 Elsevier España, S.L. All rights reserved.

  3. How ready are our health systems to implement prevention of mother to child transmission Option B+?

    Directory of Open Access Journals (Sweden)

    Palesa Nkomo

    2015-04-01

    Full Text Available In January 2015, the South African National Department of Health released new consolidated guidelines for the prevention of mother to child transmission (PMTCT of HIV, in line with the World Health Organization’s (WHO PMTCT Option B+. Implementing these guidelines should make it possible to eliminate mother to child transmission (MTCT of HIV and improve long-term maternal and infant outcomes. The present article summarises the key recommendations of the 2015 guidelines and highlights current gaps that hinder optimal implementation; these include late antenatal booking (as a result of poor staff attitudes towards ‘early bookers’ and foreigners, unsuitable clinic hours, lack of transport to facilities, quota systems being applied to antenatal clients and clinic staff shortages; poor compliance with rapid HIV testing protocols; weak referral systems with inadequate follow-up; inadequate numbers of laboratory staff to handle HIV-related monitoring procedures and return of results to the correct facility; and inadequate supply chain management, leading to interrupted supplies of antiretroviral drugs. Additionally, recommendations are proposed on how to address these gaps. There is a need to evaluate the implementation of the 2015 guidelines and proactively communicate with ground-level implementers to identify operational bottlenecks, test solutions to these bottlenecks, and develop realistic implementation plans.

  4. Internal stress in children and parental attitude to dental treatment with passive restraint

    National Research Council Canada - National Science Library

    Tsuchihashi, Natsumi; Uehara, Naoko; Takagi, Yuzo; Miwa, Zenzo; Sugimoto, Kumiko

    2012-01-01

      PURPOSE: The purpose of this study was to examine the internal stress in uncooperative children treated under passive restraint and the changes of it in later treatments under cooperative condition with no need of restraint...

  5. Internal stress in children and parental attitude to dental treatment with passive restraint

    National Research Council Canada - National Science Library

    Tsuchihashi, Natsumi; Uehara, Naoko; Takagi, Yuzo; Miwa, Zenzo; Sugimoto, Kumiko

    2012-01-01

    PURPOSE: The purpose of this study was to examine the internal stress in uncooperative children treated under passive restraint and the changes of it in later treatments under cooperative condition with no need of restraint...

  6. Fatal thromboembolism following physical restraint in a patient with schizophrenia.

    Science.gov (United States)

    Cecchi, Rossana; Lazzaro, Antonella; Catanese, Miriam; Mandarelli, Gabriele; Ferracuti, Stefano

    2012-05-01

    Fatal thromboembolism during physical restraint in patients suffering from psychotic disorders is a very rare occurrence. In the case we present here, the criteria used in forensic pathology for the age determination of venous thrombi are applied to a case of pulmonary embolism in a patient suffering from schizophrenia who died after physical restraint. The possible association between conventional antipsychotic drugs and deep venous thrombosis, followed by pulmonary embolism, in a man with no predisposing risk factors, as well as the question concerning the appropriateness of medical care, are discussed.

  7. Nurses' and physicians' educational needs in seclusion and restraint practices.

    Science.gov (United States)

    Kontio, Raija; Välimäki, Maritta; Putkonen, Hanna; Cocoman, Angela; Turpeinen, Saija; Kuosmanen, Lauri; Joffe, Grigori

    2009-07-01

    This study aimed to explore nurses' (N= 22) and physicians' (N= 5) educational needs in the context of their perceived seclusion and restraint-related mode of action and need for support. The data were collected by focus group (N= 4) interviews and analyzed with inductive content analysis. Participants recognized a need for on-ward and problem-based education and infrastructural and managerial support. The declared high ethical principles were not in accordance with the participants' reliance on manpower and the high seclusion and restraint rates. Future educational programs should bring together written clinical guidelines, education on ethical and legal issues, and the staff's support aspect.

  8. Anatomia do sistema porta renal e suas implicações no emprego de agentes anestésicos na contenção de avestruzes (Struthio camelus Anatomy of the renal portal system and its implications for the use of anesthetic agents in the restraint of ostriches (Struthio camelus

    Directory of Open Access Journals (Sweden)

    Haley Silva de Carvalho

    2007-12-01

    Full Text Available Objetivou-se com este estudo caracterizar a anatomia do sistema porta renal e verificar sua influência sobre o protocolo anestésico xilazina, tiletamina e zolazepam na contenção de avestruzes, por comparação da administração dos fármacos nos músculos da perna ou da asa. Em cinco animais foi injetado látex nas veias femorais no sentido de drenagem e, posteriormente, as aves foram fixadas em formol a 10%, por 72 horas. Em uma ave, procedeu-se à localização, colheita e fixação das valvas portais renais em formol a 10%. O sistema porta renal apresentou-se constituído por duas veias portais renais craniais, duas veias portais renais caudais e seis valvas portais renais. Na contenção química, seis avestruzes foram pré-tratados com xilazina (1mg kg-1 e, decorridos 10 minutos, receberam tiletamina/zolazepam (6mg kg-1. Os animais foram manipulados em duas ocasiões diferentes, sendo que na primeira anestesia o protocolo foi administrado nos músculos da base das asas (GI e, após 15 dias, os mesmos animais receberam o protocolo nos músculos das pernas (GII. Os períodos de latência, hábil e de recuperação não foram diferentes entre os grupos (P>0,05. A freqüência cardíaca permaneceu abaixo dos valores basais durante a anestesia (PThis study was aimed at characterizing the anatomy of the renal portal system, and determining its influence on the anesthetic protocol xylazine, tiletamine and zolazepam, in the restraint of ostriches, compared with the administration of drugs into the leg or wing muscles. Latex was injected into the femoral veins of five animals, for drainage purposes, and the birds were then fixed in 10% formaldehyde, for 72 hours. In one bird, the renal portal valves were located, collected and fixed in 10% formaldehyde. The renal portal system consisted of two cranial renal portal veins, two caudal renal portal veins, and six renal portal valves. In the chemical restraint, six ostriches were anesthetized with

  9. Determinants of Performance of Health Systems Concerning Maternal and Child Health: A Global Approach

    Science.gov (United States)

    Pinzón-Flórez, Carlos Eduardo; Fernández-Niño, Julián Alfredo; Ruiz-Rodríguez, Myriam; Idrovo, Álvaro J.; Arredondo López, Abel Armando

    2015-01-01

    Aims To assess the association of social determinants on the performance of health systems around the world. Methods A transnational ecological study was conducted with an observation level focused on the country. In order to research on the strength of the association between the annual maternal and child mortality in 154 countries and social determinants: corruption, democratization, income inequality and cultural fragmentation, we used a mixed linear regression model for repeated measures with random intercepts and a conglomerate-based geographical analysis, between 2000 and 2010. Results Health determinants with a significant association on child mortality(<1year): higher access to water (βa Quartile 4(Q4) vs Quartile 1(Q1) = -6,14; 95%CI: -11,63 to -0,73), sanitation systems, (Q4 vs Q1 = -25,58; 95%CI: -31,91 to -19,25), % measles vaccination coverage (Q4 vs Q1 = -7.35; 95%CI: -10,18 to -4,52), % of births attended by a healthcare professional (Q4 vs Q1 = -7,91; 95%CI: -11,36 to -4,52) and a % of the total health expenditure (Q3 vs Q1 = -2,85; 95%CI: -4,93 to -0,7). Ethnic fragmentation (Q4 vs Q1 = 9,93; 95%CI: -0.03 to 19.89) had a marginal effect. For child mortality<5 years, an association was found for these variables and democratization (not free vs free = 11,23; 95%CI: -0,82 to 23,29), out-of-pocket expenditure (Q1 vs Q4 = 17,71; 95%CI: 5,86 to 29,56). For MMR (Maternal mortality ratio), % of access to water for all the quartiles, % of access to sanitation systems, (Q3 vs Q1 = -171,15; 95%CI: -281,29 to -61), birth attention by a healthcare professional (Q4 vs Q1 = -231,23; 95%CI: -349,32 to -113,15), and having corrupt government (Q3 vs Q1 = 83,05; 95%CI: 33,10 to 133). Conclusions Improving access to water and sanitation systems, decreasing corruption in the health sector must become priorities in health systems. The ethno-linguistic cultural fragmentation and the detriment of democracy turn out to be two factors related to health results. PMID

  10. Determinants of performance of health systems concerning maternal and child health: a global approach.

    Directory of Open Access Journals (Sweden)

    Carlos Eduardo Pinzón-Flórez

    Full Text Available To assess the association of social determinants on the performance of health systems around the world.A transnational ecological study was conducted with an observation level focused on the country. In order to research on the strength of the association between the annual maternal and child mortality in 154 countries and social determinants: corruption, democratization, income inequality and cultural fragmentation, we used a mixed linear regression model for repeated measures with random intercepts and a conglomerate-based geographical analysis, between 2000 and 2010.Health determinants with a significant association on child mortality(<1year: higher access to water (βa Quartile 4(Q4 vs Quartile 1(Q1 = -6,14; 95%CI: -11,63 to -0,73, sanitation systems, (Q4 vs Q1 = -25,58; 95%CI: -31,91 to -19,25, % measles vaccination coverage (Q4 vs Q1 = -7.35; 95%CI: -10,18 to -4,52, % of births attended by a healthcare professional (Q4 vs Q1 = -7,91; 95%CI: -11,36 to -4,52 and a % of the total health expenditure (Q3 vs Q1 = -2,85; 95%CI: -4,93 to -0,7. Ethnic fragmentation (Q4 vs Q1 = 9,93; 95%CI: -0.03 to 19.89 had a marginal effect. For child mortality<5 years, an association was found for these variables and democratization (not free vs free = 11,23; 95%CI: -0,82 to 23,29, out-of-pocket expenditure (Q1 vs Q4 = 17,71; 95%CI: 5,86 to 29,56. For MMR (Maternal mortality ratio, % of access to water for all the quartiles, % of access to sanitation systems, (Q3 vs Q1 = -171,15; 95%CI: -281,29 to -61, birth attention by a healthcare professional (Q4 vs Q1 = -231,23; 95%CI: -349,32 to -113,15, and having corrupt government (Q3 vs Q1 = 83,05; 95%CI: 33,10 to 133.Improving access to water and sanitation systems, decreasing corruption in the health sector must become priorities in health systems. The ethno-linguistic cultural fragmentation and the detriment of democracy turn out to be two factors related to health results.

  11. Parental practice of child car safety in Enugu, Southeast Nigeria

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    Ndu KI

    2016-11-01

    Full Text Available KI Ndu,1,* U Ekwochi,1,* DC Osuorah,2,* OC Ifediora,3 FO Amadi,1 IN Asinobi,1 OW Okenwa,1 JC Orjioke,1 FN Ogbuka,1 TO Ulasi4 1Department of Paediatrics, Enugu State University of Science and Technology, Enugu State, Engu, Nigeria; 2Child Survival Unit, Medical Research Council UK, The Gambia Unit, Fajara, Gambia; 3Griffiths University Medical School, Gold Coast, QLD, Australia; 4Department of Paediatrics, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria *These authors contributed equally to this work Abstract: Child safety restraints and seat belts are regarded as the most successful safety and cost-effective protective devices available to vehicle occupants, which have saved millions of lives. This cross-sectional descriptive study evaluated the practice and use of child car restraints (CCRs among 458 purposively selected respondents resident in two local government areas in Enugu State, Nigeria. Self-administered questionnaires were sent to parents of children attending private schools who owned a car. Chi-square and multivariate analyses were used to assess the determinants of the use of car restraints in children among respondents. In all, 56% and 45% of adults and children, respectively, used car restraints regularly. The awareness of child safety laws and actual use of age-appropriate CCRs among respondents was negatively and weakly correlated (r=–0.121, P=0.310. Only respondent’s use of seat belt during driving (P=0.001 and having being cautioned for non-use of CCRs (P=0.005 maintained significance as determinants of the use of CCRs in cars on multivariate analysis. The most frequent reasons given for the non-use of CCRs included the child being uncomfortable, 64 (31%; restraints not being important, 53 (26%, and restraints being too expensive, 32 (15%. Similarly, for irregular users, exceptions for non-use included the child being asleep (29%, inadequate number of CCRs (22%, and the child being sick (18

  12. Dissemination of a Multilevel Evidence-Based System of Parenting Interventions with Broad Application to Child Welfare Populations

    Science.gov (United States)

    Prinz, Ron

    2009-01-01

    Parenting interventions are relevant to many touch points of the child welfare system. This paper describes a multilevel system of parenting interventions called "Triple P" that matches intervention intensities to families, builds on a strong scientific base, provides multiple access points for parents, and offers a destigmatized, cost-efficient…

  13. A Critical Assessment of Child Custody Evaluations: Limited Science and a Flawed System.

    Science.gov (United States)

    Emery, Robert E; Otto, Randy K; O'Donohue, William T

    2005-07-01

    further scientific investigation. We see the system for resolving custody disputes as deeply flawed, for reasons that go beyond the problem of limited science. The coupling of the vague "best interests of the child" test with the American adversary system of justice puts judges in the position of trying to perform an impossible task, and it exacerbates parental conflict and problems in parenting and coparenting, which psychological science clearly shows to be key factors predicting children's psychological difficulties in response to their parents' separation and divorce. Our analysis of the flawed system, together with our desire to sharply limit custody disputes and custody evaluations, leads us to propose three reforms. First, we urge continued efforts to encourage parents to reach custody agreements on their own-in divorce mediation, through collaborative law, in good-faith attorney negotiations, in therapy, and in other forums. Some such efforts have been demonstrated to improve parent-parent and parent-child relationships long after divorce, and they embrace the philosophical position that, in the absence of abuse or neglect, parents themselves should determine their children's best interests after separation, just as they do in marriage. Second, we urge state legislatures to move toward adopting more clear and determinative custody rules, a step that would greatly clarify the terms of the marriage contract, limit the need for custody evaluations, and sharply narrow the scope of the evaluation process. We find particular merit in the proposed "approximation rule" (recently embraced by the American Law Institute), in which postdivorce parenting arrangements would approximate parenting involvement in marriage. Third and finally, we recommend that custody evaluators follow the law and only offer opinions for which there is an adequate scientific basis. Related to this, we urge professional bodies to enact more specific standards of practice on this and related issues.

  14. Use of Physical Restraints in Dutch Intensive Care Units: A Prospective Multicenter Study

    NARCIS (Netherlands)

    Kooi, A.W. van der; Peelen, L.M.; Raijmakers, R.J.; Vroegop, R.L.; Bakker, D.F.; Tekatli, H.; Boogaard, M.H.W.A. van den; Slooter, A.J.

    2015-01-01

    BACKGROUND: Increasing evidence indicates that harmful effects are associated with the use of physical restraint. OBJECTIVES: To characterize the use of physical restraint in intensive care units. Prevalence, adherence to protocols, and correlates of the use of physical restraint were determined.

  15. Public Policy on Physical Restraint of Children with Disabilities in Public Schools

    Science.gov (United States)

    McAfee, James K.; Schwilk, Christopher; Mitruski, Megan

    2006-01-01

    The US Constitution, federal and state legislatures, courts, and regulations permit physical restraint for both therapeutic (i.e., behavior change) and risk prevention purposes. Although most venues limit restraint as punishment, no government entity prohibits use of physical restraint as a response to imminent danger. This paper provides a…

  16. The Social Validation of Three Physical Restraint Procedures: A Comparison of Young People and Professional Groups.

    Science.gov (United States)

    McDonnell, Andrew A.; Sturmey, Peter

    2000-01-01

    Forty-one special education professionals and classroom aides, 47 residential care staff, and 74 high school students rated the treatment acceptability of three forms of physical restraint. A chair method of restraint was rated as more acceptable than other floor restraint methods by all three groups. (Contains references.) (Author/CR)

  17. A Theoretical Analysis of Potential Extinction Properties of Behavior-Specific Manual Restraint

    Science.gov (United States)

    Cipani, Ennio; Thomas, Melvin; Martin, Daniel

    2007-01-01

    This paper will examine possible extinction properties of behavior-specific manual restraint. It will analyze the possibility of extinction being produced via restraint with respect to the target behavior's possible environmental functions. The theoretical analysis will involve the analysis of behavioral properties of restraint during two temporal…

  18. An Analysis of the Restraint Event and Its Behavioral Effects on Clients and Staff.

    Science.gov (United States)

    Jones, Robert J.; Timbers, Gary D.

    2002-01-01

    Programs serving troubled youth continuously struggle with the issue of using physical restraints and other coercive interventions. This paper revisits the issues and motivations surrounding restraint use. It offers an analytic perspective on the physical restraint cycle and the factors that tend to support its recurrence. (JDM)

  19. Public Policy on Physical Restraint of Children with Disabilities in Public Schools

    Science.gov (United States)

    McAfee, James K.; Schwilk, Christopher; Mitruski, Megan

    2006-01-01

    The US Constitution, federal and state legislatures, courts, and regulations permit physical restraint for both therapeutic (i.e., behavior change) and risk prevention purposes. Although most venues limit restraint as punishment, no government entity prohibits use of physical restraint as a response to imminent danger. This paper provides a…

  20. Integrating reproductive and child health and HIV services in Tanzania: Implication to policy, systems and services.

    Science.gov (United States)

    Mutalemwa, Prince P; Kisinza, William N; Munga, Michael; Urassa, Janesta A E; Kibona, Stafford; Mwingira, Upendo; Lasway, Christina; Kilima, Stella; Tenu, Filemoni; Mujaya, Stella; Kisoka, William J

    2013-04-01

    In Tanzania, reproductive health and HIV services are coordinated by the Ministry of Health and Social Welfare in two separate units namely Reproductive and Child Health Section and the National AIDS Control Programme. The importance of integrating the two services that are vertically run is expected to improve access to and uptake of key essential services and extend coverage to underserved and vulnerable populations and thus minimizing missed opportunities. Experts around the world recognize the central role of Sexual and Reproductive Health (SRH) services in preventing HIV infection. Evidence suggests that improving access to contraception for women to prevent pregnancy is an important and cost-effective way to prevent HIV-positive births. Integrating SRH and HlV services therefore verifies its importance for improving maternal and child health as well as leading to prevention of HIV infection. The primary objective of this review was to gain an understanding of the current linkages between SRH and HIV within Tanzania's policies, programmes, systems and services. Policy documents, guidelines, national laws, and published reports on SRH and HIV were reviewed. The majority of the reviewed documents mentioned fundamentals of integration between SRH and HIV. Majority of policies and guidelines both in family planning (FP) and HIV documents mandate bi-directional linkages. This review suggests that there are linkages between the two services and can be operationalised together. However, policies and guidelines only specify services to be integrated without due consideration of resources and structural orientation for linked services.

  1. Sensitization of restraint-induced corticosterone secretion after chronic restraint in rats: Involvement of 5-HT7 receptors

    OpenAIRE

    García-Iglesias, Brenda B.; Mendoza-Garrido, María E; Gutiérrez-Ospina, Gabriel; Rangel-Barajas, Claudia; Noyola-Díaz, Martha; Terrón, José A.

    2013-01-01

    Serotonin (5-HT) modulates the hypothalamic-pituitary-adrenal (HPA) axis response to stress. We examined the effect of chronic restraint stress (CRS; 20 min/day) as compared to control (CTRL) conditions for 14 days, on: 1) restraint-induced ACTH and corticosterone (CORT) secretion in rats pretreated with vehicle or SB-656104 (a 5-HT7 receptor antagonist); 2) 5-HT7 receptor-like immunoreactivity (5-HT7-LI) and protein in the hypothalamic paraventricular nucleus (PVN) and adrenal glands (AG); 3...

  2. [Pulmonary embolism in an acute manic patient following physical restraint].

    Science.gov (United States)

    Pirsoul, S; De Backer, L; Schrijvers, D

    2014-01-01

    Immobilisation is a risk factor for the development of deep venous thrombosis and pulmonary embolism. We present a case-study in which a patient developed a pulmonary embolism after being immobilised after a short period while subjected to physical restraint. We discuss the risk factors involved and stress the need for research into the prevention of such incidents.

  3. Effect of physical restraint on glucose tolerance in cynomolgus monkeys.

    Science.gov (United States)

    Shirasaki, Yasufumi; Yoshioka, Naoya; Kanazawa, Kanpei; Maekawa, Tsuyoshi; Horikawa, Tadahiro; Hayashi, Toshiaki

    2013-06-01

    Physiologic stress has been demonstrated to impair glucose tolerance. Glucose tolerance tests were performed using six cynomolgus monkeys. Chair-restrained subjects elicited higher elevations of plasma glucose and cortisol compared with squeezing device-restrained subjects. The responses to a glucose challenge are altered by different restraint procedures.

  4. The Use of Physical Restraint in Norwegian Adult Psychiatric Hospitals

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    Rolf Wynn

    2015-01-01

    Full Text Available Background. The use of coercion within the psychiatric services is problematic and raises a range of ethical, legal, and clinical questions. “Physical restraint” is an emergency procedure used in psychiatric hospitals to control patients that pose an imminent physical danger. We wished to review the literature published in scientific peer-reviewed journals describing studies on the use of physical restraint in Norway, in order to identify the current state of knowledge and directions for future research. Design. The databases PubMed, PsycINFO, CINAHL, Web of Science, and Embase were searched for studies relating to physical restraint (including holding in Norwegian psychiatric hospitals, supplemented with hand searches. Results. 28 studies were included. Most of the studies were on rates of restraint, but there were also some studies on perceptions of patients and staff, case studies, and ethnographic studies. There was only one intervention study. There are differences in use between wards and institutions, which in part may be explained by differences in patient populations. Staff appear to be less negative to the use of restraint than patients. Conclusions. The studies that were identified were primarily concerned with rates of use and with patients’ and staff’s perspectives. More interventional studies are needed to move the field forward.

  5. The Cost of Prior Restraint: "U. S. v. The Progressive."

    Science.gov (United States)

    Soloski, John; Dyer, Carolyn Stewart

    Increased litigation and rising litigation costs threaten the future of newspapers and magazines. A case study was conducted to determine the costs and effects of "United States v. 'The Progressive,'" a prior restraint case over the publication in 1979 of an article on the hydrogen bomb. "The Progressive," which operates at a deficit, spent almost…

  6. Restraints in daily care for people with moderate intellectual disabilities

    NARCIS (Netherlands)

    van der Meulen, A.P.S.; Hermsen, Maaike; Embregts, P.J.C.M.

    2016-01-01

    Background: Self-determination is an important factor in improving the quality of life of people with moderate intellectual disabilities. A focus on self-determination implies that restraints on the freedom of people with intellectual disabilities should be decreased. In addition, according to the D

  7. Restraints in daily care for people with moderate intellectual disabilities

    NARCIS (Netherlands)

    van der Meulen, A.P.S.; Hermsen, Maaike; Embregts, P.J.C.M.

    2017-01-01

    Background: Self-determination is an important factor in improving the quality of life of people with moderate intellectual disabilities. A focus on self-determination implies that restraints on the freedom of people with intellectual disabilities should be decreased. In addition, according to the

  8. Restraint stress and social defeat: What they have in common.

    Science.gov (United States)

    Motta, Simone Cristina; Canteras, Newton Sabino

    2015-07-01

    Bob Blanchard was a great inspiration for our studies on the neural basis of social defense. In the present study, we compared the hypothalamic pattern of activation between social defeat and restraint stress. As important stress situations, both defeated and immobilized animals displayed a substantial increase in Fos in the parvicellular part of the paraventricular nucleus,mostly in the region that contains the CRH neurons. In addition, socially defeated animals, but not restrained animals, recruited elements of the medial hypothalamic conspecific-responsive circuit, a region also engaged in other forms of social behavior. Of particular interest, both defeated and immobilized animals presented a robust increase in Fos expression in specific regions of the lateral hypothalamic area (i.e., juxtaparaventricular and juxtadorsomedial regions) likely to convey septo-hippocampal information encoding the environmental boundary restriction observed in both forms of stress, and in the dorsomedial part of the dorsal premammillary nucleus which seems to work as a key player for the expression of, at least, part of the behavioral responses during both restraint and social defeat. These results indicate interesting commonalities between social defeat and restraint stress, suggesting, for the first time, a septo-hippocampal–hypothalamic path likely to respond to the environmental boundary restriction that may act as common stressor component for both types of stress. Moreover, the comparison of the neural circuits mediating physical restraint and social defense revealed a possible path for encoding the entrapment component during social confrontation.

  9. Paramagnetism-Based Restraints for Xplor-NIH

    Energy Technology Data Exchange (ETDEWEB)

    Banci, Lucia; Bertini, Ivano, E-mail: ivanobertini@cerm.unifi.it; Cavallaro, Gabriele; Giachetti, Andrea [University of Florence, CERM and Department of Chemistry (Italy); Luchinat, Claudio; Parigi, Giacomo [University of Florence, CERM and Department of Agricultural Biotechnology (Italy)

    2004-03-15

    Modules that use paramagnetism-based NMR restraints have been developed and integrated in the well known program for solution structure determination Xplor-NIH; the complete set of such modules is called PARArestraints for Xplor-NIH. Paramagnetism-based restraints are paramagnetic relaxation enhancements, pseudocontact shifts, residual dipolar couplings due to metal and overall magnetic anisotropy, and cross correlation between Curie relaxation and nuclear-nuclear dipolar relaxation. The complete program has been tested by back-calculating NOEs and paramagnetism-based restraints from the X-ray structure of cytochrome c{sub 553} from B. pasteurii. Furthermore, the same experimental restraints previously used to determine the solution structure of cytochrome c{sub 553} itself, of cytochrome b{sub 5}, and of calbindin D{sub 9k} with the program PARAMAGNETIC DYANA, have been used for structure calculations by using PARArestraints for Xplor-NIH. The agreement between the two programs is quite satisfactory and validates both protocols.

  10. Lip twitch restraint on rebound tonometry in horses

    Directory of Open Access Journals (Sweden)

    Maria Cristina Caldart de Andrade

    2016-01-01

    Full Text Available ABSTRACT: The purpose of this study was to verify the effect of the upper lip twitch restraint on intraocular pressure (IOP of healthy horses. In this study, forty five Criollo horses, aged between two to 20 years (male or female were evaluated with rebound tonometer, with and without upper lip twitch restraint. A previous ophthalmic examination was performed with Schirmer tear test, fluorescein test, slit lamp biomicroscopy and direct ophthalmoscopy in all horses. Only healthy animals with no ocular findings were used. The order of the IOP measurements (with or without twitch and order of the eye (right or left were randomized. Three measurements of each eye were made and the mean was calculated. Head position was kept above the heart level and no pressure was made over eyelids. At least 10 minutes passed between the evaluations of the same horse. Measurements were made between 3:30 and 5:30pm to avoid circadian fluctuation of intraocular pressure. Statistical analysis was performed with SAS 9.2 software. A Split plot factorial design was used where horses were considered blocks. The mean intraocular pressure values obtained with lip twitch restraint (34.68±6.47mmHg were significantly higher (P<0.05 than those obtained without (29.35±4.08mmHg. There was no relevant statistical difference between right and left eyes. The restraint of horses with upper lip twitch increased equine intraocular pressure measured with the rebound tonometry.

  11. Patterns of mental health, substance abuse, and justice system involvement among youth aging out of child welfare.

    Science.gov (United States)

    Shook, Jeffrey; Goodkind, Sara; Pohlig, Ryan T; Schelbe, Lisa; Herring, David; Kim, Kevin H

    2011-07-01

    Although research on youth aging out of the child welfare system has increased, there has been limited focus on how their experiences vary. In particular, there is a need to examine patterns in the involvement of these youth in other systems, which indicate constellations of challenges facing these young people as they transition out of care and into adulthood. Using administrative data from a large birth cohort of individuals born between 1985 and 1994 whose families have been involved in the child welfare system, this article presents an analysis of the mental health, substance abuse, juvenile justice, and criminal justice system involvement of youth who have aged out of child welfare. Using a 2-step cluster analysis, we identify 5 subgroups of youth. Two of these groups, accounting for almost half of the youth, have little other system involvement and have child welfare care careers of relative stability. The other 3 groups, consisting of just over half of the youth, have much more extensive other system involvement, as well as care careers marked by instability and a greater proportion of time spent in congregate care.

  12. [Physical restraint use in critical care units. Perceptions of patients and their families].

    Science.gov (United States)

    Pérez de Ciriza Amatriain, A I; Nicolás Olmedo, A; Goñi Viguria, R; Regaira Martínez, E; Margall Coscojuela, M A; Asiain Erro, M C

    2012-01-01

    The use of physical restraints in Intensive Care Units (ICU) is common although little is known about patients' and relatives' perceptions of this use. 1) To analyze the prevalence and use of physical restraints in a general adult ICU; 2) to know the perceptions of patients who experienced use of physical restraints and; 3) to know the perceptions of relatives of patients who used physical restraints. This descriptive study, which used both quantitative and qualitative methods, was carried out in an adult ICU. For the first objective, all the patients (101) who had used any kind of physical restraint were analysed. For the second and third objectives, 30 patients and 30 relatives were interviewed using the guidelines of Strumpf & Evans as modified by Hardin (1993). All interviews were recorded, fully transcribed and then submitted to a language content analysis using the method of Hsieh & Shannon. The only physical restraint used was the wrist restraint with a prevalence of 43.47%. Seventy-two percent of patients wore the restraint ≤12h and 28%>12h. Analysis of the patient interviews revealed 4 main themes: acceptance of the restraint conditioned by beliefs and information provided; feelings and sensations caused by the use of the restraint; alternatives proposed and future repercussions. Three themes emerged from the interviews with relatives: impressions caused by the use of the restrictions; reasons for accepting or rejecting them; alternatives to the use of restraints. Most patients used physical restraints for a short period of time and only the wrist restraint was used. Patients using physical restraints and their relatives expressed a wide range of feelings and sensations, with no negative future repercussions. In general, they agreed with the use of restraints although more precise information would lead to greater acceptance. Copyright © 2011 Elsevier España, S.L. y SEEIUC. All rights reserved.

  13. Impact of trauma system preparedness on the outcomes of severe injuries among child populations.

    Science.gov (United States)

    Afifi, Raouf

    2012-12-01

    Severe child trauma poses a heavy burden upon the public's health and the nations' economies, in terms of mortality, morbidity, and disability. The burden varies by the maturity level of the adopted trauma system. This work aimed to identify the impact of trauma system maturity on the outcomes of care of severely injured children. Discharge data for the hospitalized trauma children in Florida (mature trauma system) and Indiana (immature trauma system) were retrospectively analyzed. All severely injured children, 1-15 years of age with an injury severity score ≥25 during 1999-2000 were included. Assessment involved the differences in specified treatment procedures, survival rates, hospital length of stay, and the need for post-hospital institutional care. Analysis revealed that Indiana children significantly stay longer in hospital, and that no differences in the rates of patient mortality, discharge-home, and selected procedures were found. Trauma system maturity impacts the volume and complexity of interventions, as well as the mortality, morbidity, and disability associated with severe children and adolescent trauma. The cost of such burden could be directed to improving the quality of the state's injury management services.

  14. Survey of the Child Neurology Program Coordinator Association: Workforce Issues and Readiness for the Next Accreditation System.

    Science.gov (United States)

    Feist, Terri B; Campbell, Julia L; LaBare, Julie A; Gilbert, Donald L

    2016-03-01

    In preparation for the implementation of the Next Accreditation System in Child Neurology, the authors organized the first meeting of child neurology program coordinators in October 2014. A workforce and program-readiness survey was conducted initially. Coordinator job titles varied widely. Most respondents (65%) managed 1 or more fellowships plus child neurology residency. Most had worked in graduate medical education less than 5 years (53%), with no career path (88%), supervised by someone without graduate medical education experience (85%), in divisions where faculty knowledge was judged inadequate (72%). A small proportion of programs had established clinical competency committee policies (28%) and was ready to implement milestone-based evaluations (56%). A post-conference survey demonstrated substantial improvements in relevant skills. The complexity of residency program management in the Next Accreditation System era supports substantive modifications to the program coordinator role. Such changes should include defined career pathway, managerial classification, administrative support, and continuing education. © The Author(s) 2015.

  15. Incremental health system reform policy: Ecuador's law for the provision of free maternity and child care.

    Science.gov (United States)

    Chiriboga, Sonia Ruiz

    2009-01-01

    This study assessed the impact that the Ley de Maternidad Gratuita y Atencion a la Infancia (LMGAI) [Law for the Provision of Free Maternity and Child Care] in Ecuador has had on health services utilization and infant mortality. These outcomes were also examined by socioeconomic status. This retrospective study used demographic and health surveys, ENDEMAIN 1999 and 2004, with multivariate logistic regression to assess the impact post-LMGAI, controlling for mother's socioeconomic status, maternal and birth history, and demographic characteristics. Primary healthcare services utilization outcomes significantly improved post-LMGAI. Neonatal mortality decreased post-LMGAI. Further evaluation is needed as implementation continues to understand the expansion of primary healthcare services in future health system reforms.

  16. Scope of health systems research in Child Survival and Safe Motherhood programme.

    Science.gov (United States)

    Dutta, P K

    1993-01-01

    Editorial commentary focused on several Health System Research (HSR) approaches which exemplified some of the key issues for application of HSR for further improvement in Maternal and Child Health (MCH) services in India. The goals of HSR are to delineate health policy which improves the operations of the health care delivery system for sustainability at the district level. HSR is part of a global effort of Health For All by 2000 AD and India's Child Survival and Safe Motherhood (CSSM) program, sponsored by IDA/UNICEF. CSSM aims also to end polio by 2000 AD, eliminate neonatal tetanus by 1995, and prevent deaths and morbidity from measles, diarrheal diseases, and acute respiratory infection. MCH services will be expanded at the village, subcenter, primary health center, and community health center levels in order to reduce maternal mortality to below 2/1000 from the 1990 5/1000 and to reduce mortality of children aged 1-4 years to less than 10/1000 live births from 80/1000 by 2000 AD. States with particularly high levels of child and maternal mortality are Bihar, Uttar Pradesh, Rajasthan, and Madhya Pradesh, which have about 40% of India's population. These states have low marriage ages, low female literacy, and few women in nonagricultural employment. There are about 90 districts in these states with particularly low demographic indicators. India policy directs all CSSM work to be carried out by existing staff; the program emphasis will be training, supervision, and logistics. IEC will need to be directed to attitudinal change in rural areas and urban slums. Research has found that coverage is uneven and quality of MCH services, poor. One study will evaluate the performance over 5 years in Gwalior district in a nutrition and school health program. Another research effort will perform quality assessment of MCH care at the primary health care level and promote community awareness and increased utilization. An ongoing study is evaluating nationally the family welfare

  17. Emotional security in the family system and psychological distress in female survivors of child sexual abuse.

    Science.gov (United States)

    Cantón-Cortés, David; Cantón, José; Cortés, María Rosario

    2016-01-01

    The Emotional Security Theory (EST) was originally developed to investigate the association between high levels of interparental conflict and child maladaptative outcome. The objective of the present study was to analyze the effects of emotional security in the family system on psychological distress among a sample of young female adult survivors of child sexual abuse (CSA). The role of emotional security was investigated through the interactive effects of a number of factors including the type of abuse, the continuity of abuse, the relationship with the perpetrator and the existence of disclosure for the abuse. Participants were 167 female survivors of CSA. Information about the abuse was obtained from a self-reported questionnaire. Emotional security was assessed with the Security in the Family System (SIFS) Scale, and the Symptom Checklist-90-Revised (SCL-90-R) was used to assess psychological distress. In the total sample, insecurity (preoccupation and disengagement) was correlated with high psychological distress scores, whereas no relationship was found between security and psychological distress. The relationship between emotional insecurity and psychological distress was stronger in cases of continued abuse and non-disclosure, while the relationship between emotional security and distress was stronger in cases of extrafamilial abuse and especially isolated or several incidents and when a disclosure had been made. No interactive effect was found between any of the three emotional variables and the type of abuse committed. The results of the current study suggest that characteristics of CSA such as relationship with the perpetrator and, especially, continuity of abuse and whether or not disclosure had been made, can affect the impact of emotional security on psychological distress of CSA survivors.

  18. Sensitization of restraint-induced corticosterone secretion after chronic restraint in rats: Involvement of 5-HT7 receptors

    Science.gov (United States)

    García-Iglesias, Brenda B.; Mendoza-Garrido, María E.; Gutiérrez-Ospina, Gabriel; Rangel-Barajas, Claudia; Noyola-Díaz, Martha; Terrón, José A.

    2013-01-01

    Serotonin (5-HT) modulates the hypothalamic-pituitary-adrenal (HPA) axis response to stress. We examined the effect of chronic restraint stress (CRS; 20 min/day) as compared to control (CTRL) conditions for 14 days, on: 1) restraint-induced ACTH and corticosterone (CORT) secretion in rats pretreated with vehicle or SB-656104 (a 5-HT7 receptor antagonist); 2) 5-HT7 receptor-like immunoreactivity (5-HT7-LI) and protein in the hypothalamic paraventricular nucleus (PVN) and adrenal glands (AG); 3) baseline levels of 5-HT and 5-hydroxyindolacetic acid (5-HIAA), and 5-HIAA/5-HT ratio in PVN and AG; and 4) 5-HT-like immunoreactivity (5-HT-LI) in AG and tryptophan hydroxylase (TPH) protein in PVN and AG. On day 15, animals were subdivided into Treatment and No treatment groups. Treatment animals received an i.p. injection of vehicle or SB-656104; No Treatment animals received no injection. Sixty min later, Treatment animals were either decapitated with no further stress (0 min) or submitted to acute restraint (10, 30, 60 or 120 min); hormone serum levels were measured. No Treatment animals were employed for the rest of measurements. CRS decreased body weight gain and increased adrenal weight. In CTRL animals, acute restraint increased ACTH and CORT secretion in a time of restraint-dependent manner; both responses were inhibited by SB-656104. Exposure to CRS abolished ACTH but magnified CORT responses to restraint as compared to CTRL conditions; SB-656104 had no effect on ACTH levels but significantly inhibited sensitized CORT responses. In CTRL animals, 5-HT7-LI was detected in magnocellular and parvocellular subdivisions of PVN and sparsely in adrenal cortex. Exposure to CRS decreased 5-HT7-LI and protein in the PVN, but increased 5-HT7-LI in the adrenal cortex and protein in whole AG. Higher 5-HT and 5-HIAA levels were detected in PVN and AG from CRS animals but 5-HIAA/5-HT ratio increased in AG only. Finally, whereas 5-HT-LI was sparsely observed in the adrenal cortex

  19. Evidence-Based Practice Guideline: Changing the Practice of Physical Restraint Use in Acute Care.

    Science.gov (United States)

    Lach, Helen W; Leach, Kathy M; Butcher, Howard K

    2016-02-01

    Physical restraints continue to be used in acute care settings, despite the challenges and calls to reduce this practice. The current guideline on restraint use is updated with evidence that includes critical care settings and issues related to restraint use in acute care units. Nurses play a significant role in the use of restraints. Factors such as nurse's knowledge and patient characteristics combined with the culture and resources in health care facilities influence the practice of physical restraint use. Nurses can identify patients at high risk for restraint use; assess the potential causes of unsafe behaviors; and target interventions in the areas of physiological, psychological, and environmental approaches to address those unsafe behaviors. Members of the interdisciplinary team can provide additional consultation, and institutions can provide resources and education and implement monitoring processes and quality improvement practices to help reduce the practice of physical restraint use. [Journal of Gerontological Nursing, 42(2), 17-26.]. Copyright 2016, SLACK Incorporated.

  20. Effects of dietary restraint and body mass index on the relative reinforcing value of snack food.

    Science.gov (United States)

    Goldfield, Gary S; Lumb, Andrew

    2009-01-01

    The present study examined the independent and interactive association between dietary restraint, body mass index (BMI) and the relative reinforcing value of food. Four hundred and three introductory psychology students completed questionnaires assessing age, gender, BMI, hunger, smoking status, nicotine dependence, dietary restraint, hedonic ratings for snack food and fruits and vegetables and the relative reinforcing value of snack food and fruits and vegetables. In the overall sample, results indicated a dietary restraint x BMI interaction after controlling for age, hunger, nicotine dependence, and hedonics. However, when regression models were separated by gender, the BMI x restraint interaction emerged only for females and not for males. Findings suggest that BMI moderates the relationship between dietary restraint and snack food reinforcement in females only, such that restraint and snack food reinforcement are inversely correlated in females with lower BMI, but restraint is positively correlated with snack food reinforcement in females with higher BMI. Theoretical and clinical implications of these findings are discussed.

  1. The common European asylum system and the rights of the child : an exploration of meaning and compliance

    NARCIS (Netherlands)

    Smyth, Ciara Mary

    2013-01-01

    This thesis addresses the question of whether the EU Common European Asylum System (CEAS) complies with the rights of the child. A significant proportion of people seeking asylum in EU countries are children. These children may be totally alone, with people who are not their customary caregivers o

  2. Suicide Ideation, Depressive Symptoms, and Out-of-Home Placement among Youth in the U.S. Child Welfare System

    Science.gov (United States)

    Anderson, Heather D.

    2011-01-01

    The objectives of this study were to describe the association between type of placement, depressive symptoms, and suicide ideation among a sample of youth (7 years and older) as they entered the child welfare system and to examine the longitudinal effect of prior out-of-home placements and prior depressive symptoms on subsequent suicide ideation…

  3. NDTAC Practice Guide: Quality Education Services Are Critical for Youth Involved with the Juvenile Justice and Child Welfare Systems

    Science.gov (United States)

    Gonsoulin, Simon; Clark, Heather Griller; Rankin, Victoria E.

    2015-01-01

    This National Evaluation and Technical Assistance Center for the Education of Children and Youth Who are Neglected, Delinquent, or At-Risk (NDTAC) practice guide examines the principle that quality education services are critical for youth involved with the juvenile justice and child welfare systems. This principle asserts that, to address the…

  4. New Mexico Look for the STARS--AIM HIGH: QRS Profile. The Child Care Quality Rating System (QRS) Assessment

    Science.gov (United States)

    Child Trends, 2010

    2010-01-01

    This paper presents a profile of New Mexico's Look for the STARS--AIM HIGH prepared as part of the Child Care Quality Rating System (QRS) Assessment Study. The profile consists of several sections and their corresponding descriptions including: (1) Program Information; (2) Rating Details; (3) Quality Indicators for Center-Based Programs; (4)…

  5. New Mexico Look for the STARS--AIM HIGH: QRS Profile. The Child Care Quality Rating System (QRS) Assessment

    Science.gov (United States)

    Child Trends, 2010

    2010-01-01

    This paper presents a profile of New Mexico's Look for the STARS--AIM HIGH prepared as part of the Child Care Quality Rating System (QRS) Assessment Study. The profile consists of several sections and their corresponding descriptions including: (1) Program Information; (2) Rating Details; (3) Quality Indicators for Center-Based Programs; (4)…

  6. Collaborative Research in Child Welfare: A Rationale for Rigorous Participatory Evaluation Designs to Promote Sustained Systems Change

    Science.gov (United States)

    Collins-Camargo, Crystal; Shackelford, Kim; Kelly, Michael; Martin-Galijatovic, Ramie

    2011-01-01

    Expansion of the child welfare evidence base is a major challenge. The field must establish how organizational systems and practice techniques yield outcomes for children and families. Needed research must be grounded in practice and must engage practitioners and administrators via participatory evaluation. The extent to which successful practices…

  7. Chromoblastomycosis associated with bone and central nervous involvement system in an immunocompetent child caused by exophiala spinifera

    Directory of Open Access Journals (Sweden)

    Sahana M Srinivas

    2016-01-01

    Full Text Available Chromoblastomycosis is a chronic granulomatous infection of the skin and subcutaneous tissue caused by specific group of dematiaceous fungi. The infection results from traumatic injury and is seen more commonly on feet and lower legs. It is rarely seen in children and metastatic spread to other systems is exceptionally rare. We report a 12-year-old immunocompetent male child diagnosed with chromoblastomycosis on the lower leg, who in a span of few months developed osteomyelitis and left hemiparesis. Fungal culture showed growth of Exophiala spinifera. Child showed good improvement with voriconazole and itraconazole after 1 year of treatment. Skin lesions healed with minimal scarring and his power improved.

  8. Chromoblastomycosis Associated with Bone and Central Nervous Involvement System in an Immunocompetent Child Caused by Exophiala Spinifera

    Science.gov (United States)

    Srinivas, Sahana M; Gowda, Vykuntaraju K; Mahantesh, S; Mannapur, Rajeshwari; Shivappa, Sanjay K

    2016-01-01

    Chromoblastomycosis is a chronic granulomatous infection of the skin and subcutaneous tissue caused by specific group of dematiaceous fungi. The infection results from traumatic injury and is seen more commonly on feet and lower legs. It is rarely seen in children and metastatic spread to other systems is exceptionally rare. We report a 12-year-old immunocompetent male child diagnosed with chromoblastomycosis on the lower leg, who in a span of few months developed osteomyelitis and left hemiparesis. Fungal culture showed growth of Exophiala spinifera. Child showed good improvement with voriconazole and itraconazole after 1 year of treatment. Skin lesions healed with minimal scarring and his power improved. PMID:27293256

  9. Intimate Relationship Challenges in Early Parenthood among Lesbian, Gay, and Heterosexual Couples Adopting via the Child Welfare System.

    Science.gov (United States)

    Goldberg, Abbie E; Kinkler, Lori A; Moyer, April M; Weber, Elizabeth

    2014-08-01

    Little research has examined the transition to parenthood among couples who adopt through the child welfare system. The current qualitative study of 84 individuals within 42 couples (17 lesbian, 13 gay, and 12 heterosexual), who were placed with a child via foster care three months earlier, examined perceived changes in their intimate relationship. Findings indicated that, like heterosexual biological-parent couples, some adoptive parents perceived the loss of their partner's undivided attention as stressful to the relationship. Adoption-specific stressors were also identified, including the need to find state-approved child care to facilitate "couple time" and the legal insecurity of foster-to-adopt placements. Although our findings were similar for heterosexual, lesbian, and gay adoptive parents, same-sex couples cited some additional stressors related to their sexual minority status. Findings have implications for individual, couple, and family practitioners who work with lesbian, gay, and heterosexual adoptive parents, particularly during their transition to parenthood.

  10. Who Owns Child Abuse?

    Directory of Open Access Journals (Sweden)

    Gerald Cradock

    2014-11-01

    Full Text Available Expectations of contemporary child protection apparatuses are strongly influenced by beliefs inherited from the nineteenth century child rescue movement. In particular, the belief that child abuse determination is obvious. However, this assumption fails to make a distinction between nineteenth century’s emphasis on impoverished environments and the twentieth century introduction of the pathological child abuser. Moreover, the proliferation of kinds of child abuse, and the need to distinguish child abusers from non-abusers, means knowledge is now spread across an array of disciplines and professions, which necessarily destabilizes the definition of child abuse. The increasing exposure of alternate care systems as potentially abusive has similarly destabilized the old common sense solution to neglected children—namely removal. Finally, as uncertainty increases, and definitions become more divergent, the question of what child abuse is, and what should be done about it, becomes increasingly politicized.

  11. Understanding Child Maltreatment: Juvenile Delinquency. From Research to Effective Program, Practice, and Systemic Solutions.

    Science.gov (United States)

    Wiig, Janet; Widom, Cathy Spatz

    This monograph details the growing body of research showing the connection between child maltreatment and juvenile delinquency. In 2000, nearly 879,000 children were victims of child abuse and neglect. Although juvenile crime has declined recently, the level of crime committed by youth remains high. This monograph describes an array of program,…

  12. The Psychological Effects of Hospitalization for the Child and Family -- Implications for the School System.

    Science.gov (United States)

    Clouser, Kenia

    The author views hospitalization of the child as a time of potential crisis for the child and family and as an area where the school can play a significant role in minimizing potential disruption. Topics covered include historical trends in hospital treatment of children, the concept of crisis intervention, parents' reactions to their children's…

  13. Understanding the Use of Psychotropic Medications in the Child Welfare System: Causes, Consequences, and Proposed Solutions

    Science.gov (United States)

    Alavi, Zakia; Calleja, Nancy G.

    2012-01-01

    Recent studies have highlighted the progressively increasing number of children prescribed psychotropic medication, while findings have illustrated significantly greater usage among child welfare-involved children. These findings have raised serious concerns among mental health and child welfare professionals as well as the general public. To…

  14. Effects of using the GlobalFiler™ multiplex system on parent-child analyses of cases with single locus inconsistency.

    Science.gov (United States)

    Ochiai, Eriko; Osawa, Motoki; Tamura, Tomonori; Minaguchi, Kiyoshi; Miyashita, Keiko; Matsushima, Yutaka; Kakimoto, Yu; Satoh, Fumiko

    2016-01-01

    Parent-child analyses sometimes reveal inconsistency of shared alleles at only one locus. This is conventionally called "single locus exclusion", which results from mutational events and the presence of null alleles. Here, in parent-child analyses of the Japanese population, we detected exclusions by using the GlobalFiler™ system comprising 21 short tandem repeat loci. One- or two-step mutations resulting from strand slippage causing gain or loss were observed in seven of 221 parent-child transmissions. The incidences of single locus inconsistency of alleles were 5.88×10(-2) and 8.40×10(-3) for paternal and maternal relationships, respectively. With calculation using a set of 15 loci in the Identifiler® multiplex system, the combined likelihood ratio (CLR) values were limited to less than 100 in all five cases accompanied by single inconsistency. The addition of six loci recovered the CLR values to over 10,000 in three cases. Application of this advanced system may increase the detected occurrence of mutational events, but it should be beneficial for inference in parent-child analyses, particularly in cases accompanied by genetic inconsistency. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  15. A systems relations model for Tier 2 early intervention child mental health services with schools: an exploratory study.

    Science.gov (United States)

    van Roosmalen, Marc; Gardner-Elahi, Catherine; Day, Crispin

    2013-01-01

    Over the last 15 years, policy initiatives have aimed at the provision of more comprehensive Child and Adolescent Mental Health care. These presented a series of new challenges in organising and delivering Tier 2 child mental health services, particularly in schools. This exploratory study aimed to examine and clarify the service model underpinning a Tier 2 child mental health service offering school-based mental health work. Using semi-structured interviews, clinician descriptions of operational experiences were gathered. These were analysed using grounded theory methods. Analysis was validated by respondents at two stages. A pathway for casework emerged that included a systemic consultative function, as part of an overall three-function service model, which required: (1) activity as a member of the multi-agency system; (2) activity to improve the system working around a particular child; and (3) activity to universally develop a Tier 1 workforce confident in supporting children at risk of or experiencing mental health problems. The study challenged the perception of such a service serving solely a Tier 2 function, the requisite workforce to deliver the service model, and could give service providers a rationale for negotiating service models that include an explicit focus on improving the children's environments.

  16. A national survey of the use of physical restraint in long-term care hospitals in Japan.

    Science.gov (United States)

    Chiba, Yumi; Yamamoto-Mitani, Noriko; Kawasaki, Maki

    2012-05-01

    To investigate the prevalence of physical restraints in the long-term care hospitals in Japan and to examine the factors of physical restraint use, including the specific skills/techniques that the staff use to minimise the restraints. Background.  Despite the national efforts to nullify physical restraint, it is still prevalent in long-term care facilities in and out of Japan. More detailed information regarding what affects physical restraint is needed. Cross-sectional mail survey. A questionnaire was sent to a nursing ward manager of the random sample of long-term care facilities in Japan. The average rate of physical restraint was 25·5%. Altogether, 81·0% of the restrained clients were under restraint for more than one month. The most prevalent method of restraint was bilateral bedrails, followed by the use of coveralls and gloves. Factors of restraint were different depending on the type of restraint, suggesting specific approaches are needed for specific type of restraint. Physical restraint is still prevalent in Japanese long-term care hospitals, and nurses need to develop effective intervention approach to redesigning practice related to physical restraints. Specialised intervention approach seems needed depending on the types of restraint. Specific approach should be developed to minimise the physical restraint in long-term care hospitals in Japan. © 2012 Blackwell Publishing Ltd.

  17. Physical restraint and near death of a psychiatric patient.

    Science.gov (United States)

    Nissen, Trygve; Rørvik, Per; Haugslett, Laila; Wynn, Rolf

    2013-01-01

    Physical restraint is used as a last resort emergency measure to calm and safeguard agitated and/or aggressive psychiatric patients. This can sometimes cause injuries, and rare fatalities have occurred. One mechanism of injury and death while in physical restraint is that of severe asphyxiation. We present the case of a hospitalized man in his mid-30s, suffering from schizophrenia. The patient was obese. He became aggressive and had to be manually restrained with a "takedown." After having been put in the prone position on the floor with a significant weight load on his body, he lost respiration and consciousness. Subsequently, he was given CPR. He regained consciousness and respiration, while the cyanosis receded in 1-2 min. Psychiatrists and pathologists should be aware that physically restraining a patient in the prone position with a significant weight load on the torso can, in rare cases, lead to asphyxiation. © 2012 American Academy of Forensic Sciences.

  18. Coping with budget restraint in a Scandinavian welfare state

    DEFF Research Database (Denmark)

    Nielsen, Annemette Ljungdalh; Holm, Lotte; Lund, Thomas Bøker

    2015-01-01

    The purpose of this study was to investigate how different types of households react to experiences of food budget restraint in Denmark. The study applied a mixed method design, based on survey data and on qualitative interviews. The qualitative data source consisted of interviews with 30...... individuals from Danish households with different socio-economic characteristics, who had carried through changes in their everyday food handling practices due to economic restraint. The quantitative data consists of a survey among 1650 members of a household consumer panel provided by the market research...... of strategies are related to different levels of food budget restrictions. Strategies applied to storing and cooking food in more efficient manners were widely practiced across all groups. Strategies which affected eating experiences, such as compromising the tastiness of food and giving up social ties involved...

  19. Physical restraint produces rapid acquisition of the pigeon's key peck

    Science.gov (United States)

    Locurto, C. M.; Travers, Tania; Terrace, H. S.; Gibbon, John

    1980-01-01

    The acquisition and maintenance of autoshaped key pecking in pigeons was studied as a function of intertrial interval. At each of six intervals, which ranged from 12 seconds to 384 seconds, four pigeons were physically restrained during training while four other pigeons were not restrained. Restrained subjects acquired key pecking faster and with less intragroup variability at each interval. The effects of restraint were specific to acquisition and were not evident in maintained responding after five postacquisition sessions. PMID:16812175

  20. Restraint stress alters neutrophil and macrophage phenotypes during wound healing.

    Science.gov (United States)

    Tymen, Stéphanie D; Rojas, Isolde G; Zhou, Xiaofeng; Fang, Zong Juan; Zhao, Yan; Marucha, Phillip T

    2013-02-01

    Previous studies reported that stress delays wound healing, impairs bacterial clearance, and elevates the risk for opportunistic infection. Neutrophils and macrophages are responsible for the removal of bacteria present at the wound site. The appropriate recruitment and functions of these cells are necessary for efficient bacterial clearance. In our current study we found that restraint stress induced an excessive recruitment of neutrophils extending the inflammatory phase of healing, and the gene expression of neutrophil attracting chemokines MIP-2 and KC. However, restraint stress did not affect macrophage infiltration. Stress decreased the phagocytic abilities of phagocytic cells ex vivo, yet it did not affect superoxide production. The cell surface expression of adhesion molecules CD11b and TLR4 were decreased in peripheral blood monocytes in stressed mice. The phenotype of macrophages present at the wound site was also altered. Gene expression of markers of pro-inflammatory classically activated macrophages, CXCL10 and CCL5, were down-regulated; as were markers associated with wound healing macrophages, CCL22, IGF-1, RELMα; and the regulatory macrophage marker, chemokine CCL1. Restraint stress also induced up-regulation of IL10 gene expression. In summary, our study has shown that restraint stress suppresses the phenotype shift of the macrophage population, as compared to the changes observed during normal wound healing, while the number of macrophages remains constant. We also observed a general suppression of chemokine gene expression. Modulation of the macrophage phenotype could provide a new therapeutic approach in the treatment of wounds under stress conditions in the clinical setting.

  1. Mental Health Nursing, Mechanical Restraint Measures and Patients’ Legal Rights

    DEFF Research Database (Denmark)

    Birkeland, Søren; Gildberg, Frederik Alkier

    2016-01-01

    Abstract: Coercive mechanical restraint (MR) in psychiatry constitute the perhaps most important exception from the common health law requirement for involving patients in health care decisions and achieving their informed consent prior to treatment. Coercive measures and particularly MR constitute...... a serious collision with patient autonomy principles, pose a particular challenge to psychiatric patients’ legal rights, and put intensified demands on health professional performance. Legal rights principles require rationale for coercive measure use be thoroughly considered and rigorously documented...

  2. Addendum to "Population-Based Prevention of Child Maltreatment: The U.S. Triple P System Population Trial".

    Science.gov (United States)

    Prinz, Ronald J; Sanders, Matthew R; Shapiro, Cheri J; Whitaker, Daniel J; Lutzker, John R

    2016-04-01

    A previous article published several years ago (Prinz et al. Prevention Science, 10, 1-12, 2009) described the main results of a place-randomized-design study focused on the prevention of child-maltreatment-related outcomes at a population level through the implementation of a multilevel system of parenting and family support (the Triple P-Positive Parenting Program). The current report, prepared at the encouragement of the journal, provides additional details about procedures, measures, and design-related decisions, presents an additional analysis of the main outcome variables, and poses questions about the study and its implications. We also offer guidance about how the field can move forward to build on this line of research. From the outset, the three designated primary child maltreatment outcomes were county-wide rates for substantiated child maltreatment cases, out-of-home placements, and hospital-treated child maltreatment injuries, derived from independent data sources available through administrative archival records. Baseline equivalence between the two intervention conditions was reaffirmed. The additional analysis, which made use of a 5-year baseline (replacing a 1-year baseline) and ANCOVA, yielded large effect sizes for all three outcomes that converged with those from the original analyses. Overall, the study underscored the potential for community-wide parenting and family support to produce population-level preventive impact on child maltreatment. Issues addressed included (1) the need for replication of population-oriented maltreatment prevention strategies like the one tested in this randomized experiment, (2) the need to demonstrate that a parenting-based population approach to maltreatment prevention can also impact children's adjustment apart from child abuse, and (3) the role of implementation science for achieving greater population reach and maintenance over time.

  3. Predictors of physical restraint in a psychiatric emergency setting.

    Science.gov (United States)

    Hadi, Fatemeh; Khosravi, Termeh; Shariat, Seyed Vahid; Jalali Nadoushan, Amir Hossein

    2015-01-01

    Considering the negative consequences of using physical restraints, we conducted this study to identify patients who are more frequently restrained in a psychiatric emergency ward as an initial step to limit the use of restraint to the minimum possible. This was a retrospective case control study conducted in Iran Psychiatric Hospital in Tehran, Iran. We reviewed the files of 607 patients who were admitted during a one year period using convenience sampling; of them, 186 were in the restrained group and 421 in the unrestrained group. Surprisingly, no significant difference was found between the restrained and unrestrained groups in demographic characteristics. The patients who were referred because of violence were diagnosed as having methamphetamine induced psychotic disorder or bipolar I disorder in manic 1episode and had a higher odds of being restrained (OR=2.51, OR=1.61, and OR=1.57 respectively). Being restrained was also associated with a longer duration of hospitalization and duration of staying in the emergency ward. Moreover, patients in their first admission were more frequently restrained. Medical and nursing staff should consider special measures for the patients who are at a higher risk for being restrained. More frequent visits and education for both patients and staff may be effective in reducing the number of physical restraints for these groups of patients.

  4. Modulation of Cortical Interhemispheric Interactions by Motor Facilitation or Restraint

    Directory of Open Access Journals (Sweden)

    Ana Cristina Vidal

    2014-01-01

    Full Text Available Cortical interhemispheric interactions in motor control are still poorly understood and it is important to clarify how these depend on inhibitory/facilitatory limb movements and motor expertise, as reflected by limb dominance. Here we addressed this problem using functional magnetic resonance imaging (fMRI and a task involving dominant/nondominant limb mobilization in the presence/absence of contralateral limb restraint. In this way we could modulate excitation/deactivation of the contralateral hemisphere. Blocks of arm elevation were alternated with absent/present restraint of the contralateral limb in 17 participants. We found the expected activation of contralateral sensorimotor cortex and ipsilateral cerebellum during arm elevation. In addition, only the dominant arm elevation (hold period was accompanied by deactivation of ipsilateral sensorimotor cortex, irrespective of presence/absence of contralateral restraint, although the latter increased deactivation. In contrast, the nondominant limb yielded absent deactivation and reduced area of contralateral activation upon restriction. Our results provide evidence for a difference in cortical communication during motor control (action facilitation/inhibition, depending on the “expertise” of the hemisphere that controls action (dominant versus nondominant. These results have relevant implications for the development of facilitation/inhibition strategies in neurorehabilitation, namely, in stroke, given that fMRI deactivations have recently been shown to reflect decreases in neural responses.

  5. Construct Validation of the Portuguese Version of the Restraint Scale

    Directory of Open Access Journals (Sweden)

    João Carvalho

    2016-08-01

    Full Text Available AimThe main purpose of this study was to adapt the Restraint Scale (RS to Portuguese and examine its psychometric properties, specifically its construct validity.MethodIn this study, 238 normal-weight adults (82% women; Mean age = 36.6, SD = 15.0 participated in an online survey containing measures of Restraint Scale, Three Factor Eating Questionnaire, Dutch Eating Behaviour Questionnaire, and Body Dissatisfaction and Drive for Thinness scales.ResultsExploratory factor analyses corroborated the two-factors structure found in previous studies, in particular when three items without clear factorial assignment and low correlation were excluded. A final two-factors version of the RS containing seven items presented a very good fit to the measurement model and good internal consistency. Confirmatory factor analysis of the 7-items RS in relation to a three-factor model of overeating, dieting and body dissatisfaction measures revealed that the RS was the only restraint measure loading in all three factors.ConclusionThis suggests that the 7-items Portuguese version of the RS has good psychometric properties and unique features that lend it appropriate to identify and study unsuccessful chronic dieters.

  6. Exploring RNA conformational space under sparse distance restraints

    Science.gov (United States)

    Taylor, William R.; Hamilton, Russell S.

    2017-01-01

    We show that the application of a small number of restraints predicted by coevolution analysis can provide a powerful restriction on the conformational freedom of an RNA molecule. The greatest degree of restriction occurs when a contact is predicted between the distal ends of a pair of adjacent stemloops but even with this location additional flexibilities in the molecule can mask the contribution. Multiple cross-links, especially those including a pseudoknot provided the strongest restraint on conformational freedom with the effect being most apparent in topologically simple folds and less so if the fold is more topologically entwined. Little was expected for large structures (over 300 bases) and although a few strong localised restrictions were observed, they contributed little to the restraint of the overall fold. Although contacts predicted using a correlated mutation analysis can provide some powerful restrictions on the conformational freedom of RNA molecules, they are too erratic in their occurrence and distribution to provide a general approach to the problem of RNA 3D structure prediction from sequence. PMID:28281575

  7. Child passenger injury risk in motor vehicle crashes: a comparison of nighttime and daytime driving by teenage and adult drivers.

    Science.gov (United States)

    Chen, Irene G; Durbin, Dennis R; Elliott, Michael R; Senserrick, Teresa; Winston, Flaura K

    2006-01-01

    To examine the association between child passenger injury risk, restraint use, and crash time (day vs. night) for children in crashes of vehicles driven by teenage versus adult drivers. Cross-sectional study involving telephone interviews with insured drivers in a probability sample of 6,184 crashes involving 10,028 children. Child passengers in teen nighttime crashes had an increased injury risk and an increased risk of restraint nonuse compared with those in teen daytime crashes. This increased injury risk can be explained by differences in the age of child passengers, collision type, and child passenger's restraint status associated with time of day. In order to limit the risk of injury to child passengers driven by teens, Graduated Driver Licensing (GDL) laws should include provisions restricting nighttime driving, as well as mandates for age-appropriate restraint for child passengers. Consideration should also be given for education in child passenger safety for novice teen drivers as part of the licensing process. Results of this study can be used to support advocacy efforts by the automotive industry and others to promote nighttime driving restrictions on novice drivers. In addition, given that both driver groups were more likely to be involved in a single-vehicle collision during the night, technologies such as electronic stability control may offer opportunities for protection. Further reseach on specific circumstances of teen nighttime crashes is needed to inform industry efforts to improve visibility or vehicle operation under poor lighting conditions.

  8. Child Care Subsidies and Child Development

    Science.gov (United States)

    Herbst, Chris M.; Tekin, Erdal

    2010-01-01

    Child care subsidies are an important part of federal and state efforts to move welfare recipients into employment. One of the criticisms of the current subsidy system, however, is that it overemphasizes work and does little to encourage parents to purchase high-quality child care. Consequently, there are reasons to be concerned about the…

  9. Child Care Subsidies and Child Development

    Science.gov (United States)

    Herbst, Chris M.; Tekin, Erdal

    2010-01-01

    Child care subsidies are an important part of federal and state efforts to move welfare recipients into employment. One of the criticisms of the current subsidy system, however, is that it overemphasizes work and does little to encourage parents to purchase high-quality child care. Consequently, there are reasons to be concerned about the…

  10. Modification of hippocampal markers of synaptic plasticity by memantine in animal models of acute and repeated restraint stress: implications for memory and behavior.

    Science.gov (United States)

    Amin, Shaimaa Nasr; El-Aidi, Ahmed Amro; Ali, Mohamed Mostafa; Attia, Yasser Mahmoud; Rashed, Laila Ahmed

    2015-06-01

    Stress is any condition that impairs the balance of the organism physiologically or psychologically. The response to stress involves several neurohormonal consequences. Glutamate is the primary excitatory neurotransmitter in the central nervous system, and its release is increased by stress that predisposes to excitotoxicity in the brain. Memantine is an uncompetitive N-methyl D-aspartate glutamatergic receptors antagonist and has shown beneficial effect on cognitive function especially in Alzheimer's disease. The aim of the work was to investigate memantine effect on memory and behavior in animal models of acute and repeated restraint stress with the evaluation of serum markers of stress and the expression of hippocampal markers of synaptic plasticity. Forty-two male rats were divided into seven groups (six rats/group): control, acute restraint stress, acute restraint stress with Memantine, repeated restraint stress, repeated restraint stress with Memantine and Memantine groups (two subgroups as positive control). Spatial working memory and behavior were assessed by performance in Y-maze. We evaluated serum cortisol, tumor necrotic factor, interleukin-6 and hippocampal expression of brain-derived neurotrophic factor, synaptophysin and calcium-/calmodulin-dependent protein kinase II. Our results revealed that Memantine improved spatial working memory in repeated stress, decreased serum level of stress markers and modified the hippocampal synaptic plasticity markers in both patterns of stress exposure; in ARS, Memantine upregulated the expression of synaptophysin and brain-derived neurotrophic factor and downregulated the expression of calcium-/calmodulin-dependent protein kinase II, and in repeated restraint stress, it upregulated the expression of synaptophysin and downregulated calcium-/calmodulin-dependent protein kinase II expression.

  11. Does Formal Integration between Child Welfare and Behavioral Health Agencies Result in Improved Placement Stability for Adolescents Engaged with Both Systems?

    Science.gov (United States)

    Wells, Rebecca; Chuang, Emmeline

    2012-01-01

    National survey data were used to assess whether child welfare agency ties to behavioral health care providers improved placement stability for adolescents served by both systems. Adolescents initially at home who were later removed tended to have fewer moves when child welfare and behavioral health were in the same larger agency. Joint training…

  12. The Process of Deinstitutionalisation and Abolition of Restraint in the Social Care Home Dutovlje

    Directory of Open Access Journals (Sweden)

    Karmen Orel

    2012-12-01

    Full Text Available Deinstitutionalization is the process that includes practical changes, and transforming the treatment of persons with mental health problems. This process counteracts the harmful effects of living in an institution. The basic steps start within the institution by strengthening the relationship of power in favour of the residents. This is very closely related to the abolition of restraint methods. The change in power relations between the actors of deinstitutionalization is also connected with the legal system. The Mental Health Act has not brought the expected results, it is largely inconsistent with both the Social Security Act, the Regulations on standards and norms for social services, as well the code of ethical principles in social work as professional principles, methods and work procedures. The Mental Health Act gives the opportunity for using the methods of restraint in a social care home where, in addition to this unethical and inhumane approach to the tenant, puts workers in trouble. The authors mention some historical data of the opening of the institutions in the world and briefly introduce an example of good practice of the process of deinstitutionalization in the Social care home Dutovlje.

  13. The central effect of biological Amines on immunosuppressive effect of restraint stress in rat

    Directory of Open Access Journals (Sweden)

    Zeraati F

    2000-10-01

    Full Text Available The effects of some histaminergic agents were evaluated on stress- induced immunosuppression in immunized nale rats. In rat immunized with sheep red blood cells ( SRBCs. Restraint stress (RS prevented the booster-induced rise in anti-SRBC antibody titre and cell immunity response. Intracerebroventicular (I.C>V injection of histamine (150 µg/rat induced a similar effect with RS. Pretreatment with chlorpheniramine (50 µg/rat reduced the inhibitory effect of Ras on immune function. Also histamine could inhibit the effect of RS on immune function. Also histamine could inhibitory the effect of chlorpheniramine when injected simultaneously. Pretreatment with ranidine (10 µg/rat had not a significant effect. Serotonin (3 µg/rat and dopamine (0.2 µg/rat could reverse the effects of chlorpheniromine when injected with chlorpheniramine (P<0.05. Epinephrine (0.2 µg/rat had not a significant effect. The results indicate that histamine mediates the immunosuppression of restraint stress by influencing the histamine H1 receptor in the brain and this effects of histamine may be modulated by serotoninergic and dopaminergic system.

  14. Incidence Rate and Patterns of Physical Restraint Use Among Adult Patients in Malaysia.

    Science.gov (United States)

    Eskandari, Fatemeh; Abdullah, Khatijah Lim; Zainal, Nor Zuraida; Wong, Li Ping

    2016-11-16

    Incidence rate and patterns of physical restraint use were examined based on a cross-sectional study in 22 wards of a large teaching hospital in Malaysia. Results indicated that the highest rate of physical restraint (19.7%) was reported from neurology-neurosurgery wards. "Un-cooperative for electroconvulsive therapy" and "trying to pull out catheters" were the most commonly reported reasons to use restraint in psychiatric and non-psychiatric wards, respectively. There were some relationships between patterns of physical restraint in this study. Exploring the incidence rate and patterns of physical restraint is important so that effective strategies can be formulated to minimize using restraint in hospitals. © The Author(s) 2016.

  15. Ensemble models of proteins and protein domains based on distance distribution restraints.

    Science.gov (United States)

    Jeschke, Gunnar

    2016-04-01

    Conformational ensembles of intrinsically disordered peptide chains are not fully determined by experimental observations. Uncertainty due to lack of experimental restraints and due to intrinsic disorder can be distinguished if distance distributions restraints are available. Such restraints can be obtained from pulsed dipolar electron paramagnetic resonance (EPR) spectroscopy applied to pairs of spin labels. Here, we introduce a Monte Carlo approach for generating conformational ensembles that are consistent with a set of distance distribution restraints, backbone dihedral angle statistics in known protein structures, and optionally, secondary structure propensities or membrane immersion depths. The approach is tested with simulated restraints for a terminal and an internal loop and for a protein with 69 residues by using sets of sparse restraints for underlying well-defined conformations and for published ensembles of a premolten globule-like and a coil-like intrinsically disordered protein.

  16. Child Abuse

    Science.gov (United States)

    ... or puts a child at risk of harm. Child abuse can be physical, sexual or emotional. Neglect, or not providing for a child's needs, is also a form of abuse. Most abused children suffer greater emotional than physical ...

  17. Child Poverty and Child Outcomes.

    Science.gov (United States)

    Bradshaw, Jonathan

    2002-01-01

    Reviews the evidence on the prevalence of child poverty in Britain including: (1) how child poverty has changed over the last 20 years; (2) how child poverty in Britain compares with that in other countries; (3) characteristics of poor children; (4) impact of poverty on child well-being; and (5) government attempts to abolish child poverty. (SD)

  18. Use of physical restraint: Nurses' knowledge, attitude, intention and practice and influencing factors.

    Science.gov (United States)

    Eskandari, Fatemeh; Abdullah, Khatijah Lim; Zainal, Nor Zuraida; Wong, Li Ping

    2017-02-23

    To investigate the knowledge, attitude, intention and practice of nurses towards physical restraint and factors influencing these variables. A literature review showed a lack of studies focused on the intention of nurses regarding physical restraint throughout the world. Considering that very little research on physical restraint use has been carried out in Malaysia, assessment of nurses' knowledge, attitude, intention and practice is necessary before developing a minimising programme in hospitals. A cross-sectional study was used. A questionnaire to assess the knowledge, attitude, intention and practice was completed by all nurses (n = 309) in twelve wards of a teaching hospital in Kuala Lumpur. Moderate knowledge and attitude with strong intention to use physical restraint were found among the nurses. Less than half of nurses considered alternatives to physical restraint and most of them did not understand the reasons for the physical restraint. Nurses' academic qualification, read any information source during past year and nurses' work unit showed a significant association with nurses' knowledge. Multiple linear regression analysis found knowledge, attitude and intention were significantly associated with nurses' practice to use physical restraint. This study showed some important misunderstandings of nurses about using physical restraint and strong intention regarding using physical restraint. Findings of this study serve as a supporting reason for importance of educating nurses about the use of physical restraint. Exploring the knowledge, attitude, intention and current practice of nurses towards physical restraint is important so that an effective strategy can be formulated to minimise the use of physical restraints in hospitals. © 2017 John Wiley & Sons Ltd.

  19. The detrimental effects of physical restraint as a consequence for inappropriate classroom behavior.

    Science.gov (United States)

    Magee, S K; Ellis, J

    2001-01-01

    Functional analyses produced inconclusive results regarding variables that maintained problem behavior for 2 students with developmental disabilities. Procedures were modified to include a contingent physical restraint condition based on in-class observations. Results indicated that tinder conditions in which physical restraint (i.e., basket-hold timeout) was applied contingent on problem behavior, rates of these behaviors increased across sessions for both subjects. Implications for the use of physical restraint in the classroom are discussed. PMID:11800190

  20. Nursing Staff Views of Barriers to Physical Restraint Reduction in Nursing Homes

    Directory of Open Access Journals (Sweden)

    Eun-Hi Kong, RN, PhD

    2012-12-01

    Conclusion: The findings of this study provide a valuable basis for developing restraint reduction education programs. Korean national leaders and nursing homes should develop and employ practice guidelines regarding restraints, support nursing staff to follow the guidelines, provide more practical and professional education, employ alternative equipment, use a multidisciplinary team approach, and engage volunteers in care support as well as employ more nursing staff to achieve restraint-free care.

  1. The detrimental effects of physical restraint as a consequence for inappropriate classroom behavior.

    Science.gov (United States)

    Magee, S K; Ellis, J

    2001-01-01

    Functional analyses produced inconclusive results regarding variables that maintained problem behavior for 2 students with developmental disabilities. Procedures were modified to include a contingent physical restraint condition based on in-class observations. Results indicated that tinder conditions in which physical restraint (i.e., basket-hold timeout) was applied contingent on problem behavior, rates of these behaviors increased across sessions for both subjects. Implications for the use of physical restraint in the classroom are discussed.

  2. Keep it together: restraints in crystallographic refinement of macromolecule–ligand complexes

    Science.gov (United States)

    Steiner, Roberto A.; Tucker, Julie A.

    2017-01-01

    A short introduction is provided to the concept of restraints in macromolecular crystallographic refinement. A typical ligand restraint-generation process is then described, covering types of input, the methodology and the mechanics behind the software in general terms, how this has evolved over recent years and what to look for in the output. Finally, the currently available restraint-generation software is compared, concluding with some thoughts for the future. PMID:28177305

  3. Service Receipt and Mental Disorders in Child Welfare and Mental Health Systems in Los Angeles County.

    Science.gov (United States)

    He, Amy S; Traube, Dorian E; Brimhall, Kim C; Lim, Caroline; Lecklitner, Greg; Olson, Adrienne

    2017-08-01

    Use of administrative data from child welfare (CW) and mental health systems in Los Angeles County provided a unique opportunity to more closely examine mental health needs of children dually served by these systems. This study examined the presence of mental disorders and correlates of receipt of mental health services by diagnostic classification in this population. Data were obtained for 3,191 children receiving services from Los Angeles County's Department of Children and Family Services and Department of Mental Health (DMH) between July 2011 and July 2012. Multivariate linear and logistic regression models examined the relationship between sociodemographic and CW-related characteristics and receipt of outpatient services by clinician-diagnosed mental disorder. Of the 3,191 referred children, 68% met criteria for one of the four diagnostic classifications. Mood disorders were the most common diagnosis (30%), followed by anxiety disorders (20%), behavior disorders (9%), and attention-deficit hyperactivity disorder (9%). Children with prior DMH involvement received more services regardless of diagnosis. Older children (ages ≥15) received more services than younger children, whereas younger children were more likely to receive family therapy. Race-ethnicity did not play a significant role in predicting service receipt. The unique mental health needs of CW-involved children were exemplified by the differences found in the percentages of children with diagnoses of mental disorders between this sample and children in the general population. Because of family and placement disruptions among CW-involved children, it is important that the provision of individual therapy is not overlooked in favor of family therapy.

  4. Neural systems and hormones mediating attraction to infant and child faces.

    Science.gov (United States)

    Luo, Lizhu; Ma, Xiaole; Zheng, Xiaoxiao; Zhao, Weihua; Xu, Lei; Becker, Benjamin; Kendrick, Keith M

    2015-01-01

    We find infant faces highly attractive as a result of specific features which Konrad Lorenz termed "Kindchenschema" or "baby schema," and this is considered to be an important adaptive trait for promoting protective and caregiving behaviors in adults, thereby increasing the chances of infant survival. This review first examines the behavioral support for this effect and physical and behavioral factors which can influence it. It then provides details of the increasing number of neuroimaging and electrophysiological studies investigating the neural circuitry underlying this baby schema effect in parents and non-parents of both sexes. Next it considers potential hormonal contributions to the baby schema effect in both sexes and the neural effects associated with reduced responses to infant cues in post-partum depression, anxiety and drug taking. Overall the findings reviewed reveal a very extensive neural circuitry involved in our perception of cuteness in infant faces, with enhanced activation compared to adult faces being found in brain regions involved in face perception, attention, emotion, empathy, memory, reward and attachment, theory of mind and also control of motor responses. Both mothers and fathers also show evidence for enhanced responses in these same neural systems when viewing their own as opposed to another child. Furthermore, responses to infant cues in many of these neural systems are reduced in mothers with post-partum depression or anxiety or have taken addictive drugs throughout pregnancy. In general reproductively active women tend to rate infant faces as cuter than men, which may reflect both heightened attention to relevant cues and a stronger activation in their brain reward circuitry. Perception of infant cuteness may also be influenced by reproductive hormones with the hypothalamic neuropeptide oxytocin being most strongly associated to date with increased attention and attraction to infant cues in both sexes.

  5. Neural systems and hormones mediating attraction to infant and child faces

    Directory of Open Access Journals (Sweden)

    Lizhu eLuo

    2015-07-01

    Full Text Available We find infant faces highly attractive as a result of specific features which Konrad Lorenz termed Kindchenschema or baby schema, and this is considered to be an important adaptive trait for promoting protective and caregiving behaviors in adults, thereby increasing the chances of infant survival. This review first examines the behavioral support for this effect and physical and behavioral factors which can influence it. It next reviews the increasing number of neuroimaging and electrophysiological studies investigating the neural circuitry underlying this baby schema effect in both parents and non-parents of both sexes. Next it considers potential hormonal contributions to the baby schema effect in both sexes and then neural effects associated with reduced responses to infant cues in post-partum depression, anxiety and drug taking. Overall the findings reviewed reveal a very extensive neural circuitry involved in our perception of cutenessin infant faces with enhanced activation compared to adult faces being found in brain regions involved in face perception, attention, emotion, empathy, memory, reward and attachment, theory of mind and also control of motor responses.Both mothers and fathers also show evidence for enhanced responses in these same neural systems when viewing their own as opposed to another child. Furthermore, responses to infant cues in many of these neural systems are reduced in mothers with post-partum depression or anxiety or have taken addictive drugs throughout pregnancy. In general reproductively active women tend to rate infant faces as cuter than men, which may reflect both heightened attention to relevant cues and a stronger activation in their brain reward circuitry. Perception of infant cuteness may also be influenced by reproductive hormones with the hypothalamic neuropeptide oxytocin being most strongly associated to date with increased attention andattractionto infant cues in both sexes.

  6. Introducing infant and young child feeding indicators into national nutrition surveillance systems: lessons from Vietnam.

    Science.gov (United States)

    Hajeebhoy, Nemat; Nguyen, Phuong Hong; Tran, Do Thanh; de Onis, Mercedes

    2013-09-01

    A comprehensive set of infant and young child feeding (IYCF) indicators for international use was published in 2008. We describe the process followed to incorporate these indicators into Vietnam's National Nutrition Surveillance System (NNSS). Following its establishment in 1980, the National Institute of Nutrition introduced the Vietnam NNSS to provide an evidence base for nutrition interventions. While anthropometric indicators based on international standards were regularly used for programme purposes, data on IYCF could not be collected with similar rigor until 2010. In 2009, with support from Alive & Thrive and UNICEF, the NNSS questionnaire was reviewed and additional content incorporated to measure IYCF practices. The tool was pilot-tested in 10 provinces and revised before nationwide roll-out in 2010.The tool comprises four pages, the first three of which focus on collecting data relating to maternal nutrition and IYCF. The last page is flexibly designed to incorporate planners' data requests for other relevant activities (e.g. mass media interventions, food security). Once analysed, the data are presented in a report comprising provincial profiles and maps illustrating IYCF practices. Importantly, the IYCF data have been used for policy advocacy (e.g. maternity leave legislation, advertisement law), programme planning, trend monitoring and capacity building. Adoption of the IYCF indicators was successful due to strategic timing, a phased approach, buy-in from stakeholders and capacity building at all levels to ensure the quality and use of data. Further revisions to the NNSS (e.g. sampling methodology, quality assurance systems) will be important to ensure the reliability of indicators.

  7. Parent Experiences with State Child Care Subsidy Systems and Their Perceptions of Choice and Quality in Care Selected

    Science.gov (United States)

    Raikes, Helen; Torquati, Julia; Wang, Cixin; Shjegstad, Brinn

    2012-01-01

    Research Findings: This study investigated parents' experiences using Child Care and Development Fund and other state-dispersed child care subsidies, reasons for choosing their current child care program, and perceptions of the quality of child care received from their current program. A telephone survey of 659 parents receiving child care…

  8. District of Columbia Going for the Gold Tiered Rate Reimbursement System. QRS Profile. The Child Care Quality Rating System (QRS) Assessment

    Science.gov (United States)

    Child Trends, 2010

    2010-01-01

    This paper presents a profile of District of Columbia's Going for the Gold Tiered Rate Reimbursement Systemp repared as part of the Child Care Quality Rating System (QRS) Assessment Study. The profile consists of several sections and their corresponding descriptions including: (1) Program Information; (2) Rating Details; (3) Quality Indicators for…

  9. Children with special health care needs: patterns of safety restraint use, seating position, and risk of injury in motor vehicle crashes.

    Science.gov (United States)

    Huang, Patty; Kallan, Michael J; O'Neil, Joseph; Bull, Marilyn J; Blum, Nathan J; Durbin, Dennis R

    2009-02-01

    Special health care needs associated with behavioral conditions may influence a child's safety in motor vehicle crashes. The aim of this study was to describe and compare variation in restraint use, seating position, and injury risk in motor vehicle crashes among children with and without special health care needs likely to affect behavior. This study uses data collected between December 1, 1998, and November 30, 2002, in a cross-sectional study of children vehicles in 15 states. Parent reports via a validated telephone survey were used to define precrash special health care needs, restraint status, seating position, and the occurrence of clinically significant injuries by using a previously validated survey instrument. Complete data were collected for 14654 children aged 4 to 15 years, representing 171633 children in crashes. Of these, 152 children were reported to have a special need likely to affect behavior, representing 1883 children. A greater proportion of children with special needs likely to affect behavior were appropriately restrained, particularly among children aged 4 to 8 years. Drivers of children with special needs likely to affect behavior were more often restrained and more often were the child passenger's parent. There were no differences in the rates of front-row seating. There was no significant association between the presence of a special need likely to affect behavior and risk of injury, after adjustment for child/driver characteristics and crash severity. Despite a greater proportion of children with special needs likely to affect behavior using proper vehicle restraint, their injury risk was similar to that of children without these special needs. Primary care pediatricians providing best practices for vehicle safety should consider the unique riding experience and risk of injury among children with special health care needs likely to affect behavior.

  10. A self-medication hypothesis for increased vulnerability to drug abuse in prenatally restraint stressed rats.

    Science.gov (United States)

    Reynaert, Marie-Line; Marrocco, Jordan; Gatta, Eleonora; Mairesse, Jérôme; Van Camp, Gilles; Fagioli, Francesca; Maccari, Stefania; Nicoletti, Ferdinando; Morley-Fletcher, Sara

    2015-01-01

    Stress-related events that occur in the perinatal period can permanently change brain and behavior of the developing individual and there is increasing evidence that early-life adversity is a contributing factor in the etiology of drug abuse and mood disorders. Neural adaptations resulting from early-life stress may mediate individual differences in novelty responsiveness and in turn contribute to drug abuse vulnerability. Prenatal restraint stress (PRS) in rats is a well-documented model of early stress known to induce long-lasting neurobiological and behavioral alterations including impaired feedback mechanisms of the HPA axis, enhanced novelty seeking, and increased sensitiveness to psychostimulants as well as anxiety/depression-like behavior. Together with the HPA axis, functional alterations of the mesolimbic dopamine system and of the metabotropic glutamate receptors system appear to be involved in the addiction-like profile of PRS rats.

  11. Evaluation of Multi Canister Overpack (MCO) Handling Machine Uplift Restraint for a Seismic Event During Repositioning Operations

    Energy Technology Data Exchange (ETDEWEB)

    SWENSON, C.E.

    2000-05-15

    Insertion of the Multi-Canister Overpack (MCO) assemblies into the Canister Storage Building (CSB) storage tubes involves the use of the MCO Handling Machine (MHM). During MCO storage tube insertion operations, inadvertent movement of the MHM is prevented by engaging seismic restraints (''active restraints'') located adjacent to both the bridge and trolley wheels. During MHM repositioning operations, the active restraints are not engaged. When the active seismic restraints are not engaged, the only functioning seismic restraints are non-engageable (''passive'') wheel uplift restraints which function only if the wheel uplift is sufficient to close the nominal 0.5-inch gap at the uplift restraint interface. The MHM was designed and analyzed in accordance with ASME NOG-1-1995. The ALSTHOM seismic analysis reported seismic loads on the MHM uplift restraints and EDERER performed corresponding structural calculations to demonstrate structural adequacy of the seismic uplift restraint hardware. The ALSTHOM and EDERER calculations were performed for a parked MHM with the active seismic restraints engaged, resulting in uplift restraint loading only in the vertical direction. In support of development of the CSB Safety Analysis Report (SAR), an evaluation of the MHM seismic response was requested for the case where the active seismic restraints are not engaged. If a seismic event occurs during MHM repositioning operations, a moving contact at a seismic uplift restraint would introduce a friction load on the restraint in the direction of the movement. These potential horizontal friction loads on the uplift restraints were not included in the existing restraint hardware design calculations. One of the purposes of the current evaluation is to address the structural adequacy of the MHM seismic uplift restraints with the addition of the horizontal friction associated with MHM repositioning movements.

  12. Staff perceptions of barriers to physical restraint-reduction in long-term care: a meta-synthesis.

    Science.gov (United States)

    Kong, Eun-Hi; Choi, Heeseung; Evans, Lois K

    2017-01-01

    To critically review the existing qualitative studies to identify, from the perspective of staff, the barriers to physical restraint reduction in long-term geriatric care facilities. Despite the adverse physical and psychosocial effects, physical restraints are still used frequently in many geriatric long-term care facilities around the world. There is, however, no study that synthesises the existing qualitative literature regarding the barriers to the restraint reduction from the perspective of facility staff. The metastudy research process guided this qualitative synthesis. Five electronic databases were searched, and ten studies were included in this metastudy. Five themes were identified through metasynthesis of the findings: concern about and responsibility for safety, unclear and inconsistent definitions of restraint and restraint-free care, difficulties in the transition from acceptance to removal, noninvolvement in decision-making to remove restraint and insufficient resources and education. A concept analysis of physical restraint is sorely needed, and future studies should explore the prevalence of restraint, the effects of education for staff and family on restraint reduction, and success stories related to restraint-free care. More research is needed regarding the restraint reduction effectiveness and cost issues. Physical restraints, commonly used in many geriatric long-term care facilities, result in many negative effects and ethical issues. To achieve success in reducing physical restraint use, governmental policies and long-term care institutions should underpin staff efforts with legal, educational and practical support. © 2016 John Wiley & Sons Ltd.

  13. Short-term effects of an educational intervention on physical restraint use: a cluster randomized trial

    Science.gov (United States)

    Huizing, Anna R; Hamers, Jan PH; Gulpers, Math JM; Berger, Martijn PF

    2006-01-01

    Background Physical restraints are still frequently used in nursing home residents despite growing evidence for the ineffectiveness and negative consequences of these methods. Therefore, reduction in the use of physical restraints in psycho-geriatric nursing home residents is very important. The aim of this study was to investigate the short-term effects of an educational intervention on the use of physical restraints in psycho-geriatric nursing home residents. Methods A cluster randomized trial was applied to 5 psycho-geriatric nursing home wards (n = 167 residents with dementia). The wards were assigned at random to either educational intervention (3 wards) or control status (2 wards). The restraint status was observed and residents' characteristics, such as cognitive status, were determined by using the Minimum Data Set (MDS) at baseline and 1 month after intervention. Results Restraint use did not change significantly over time in the experimental group (55%–56%), compared to a significant increased use (P < 0.05) in the control group (56%–70%). The mean restraint intensity and mean multiple restraint use in residents increased in the control group but no changes were shown in the experimental group. Logistic regression analysis showed that residents in the control group were more likely to experience increased restraint use than residents in the experimental group. Conclusion An educational programme for nurses combined with consultation with a nurse specialist did not decrease the use of physical restraints in psycho-geriatric nursing home residents in the short term. However, the residents in the control group experienced more restraint use during the study period compared to the residents in the experimental group. Whether the intervention will reduce restraint use in the long term could not be inferred from these results. Further research is necessary to gain insight into the long-term effects of this educational intervention. PMID:17067376

  14. Nursing Skill Mix, Nurse Staffing Level, and Physical Restraint Use in US Hospitals: a Longitudinal Study.

    Science.gov (United States)

    Staggs, Vincent S; Olds, Danielle M; Cramer, Emily; Shorr, Ronald I

    2017-01-01

    Although it is plausible that nurse staffing is associated with use of physical restraints in hospitals, this has not been well established. This may be due to limitations in previous cross-sectional analyses lacking adequate control for unmeasured differences in patient-level variables among nursing units. To conduct a longitudinal study, with units serving as their own control, examining whether nurse staffing relative to a unit's long-term average is associated with restraint use. We analyzed 17 quarters of longitudinal data using mixed logistic regression, modeling quarterly odds of unit restraint use as a function of quarterly staffing relative to the unit's average staffing across study quarters. 3101 medical, surgical, and medical-surgical units in US hospitals participating in the National Database of Nursing Quality Indicators during 2006-2010. Units had to report at least one quarter with restraint use and one quarter without. We studied two nurse staffing variables: staffing level (total nursing hours per patient day) and nursing skill mix (proportion of nursing hours provided by RNs). Outcomes were any use of restraint, regardless of reason, and use of restraint for fall prevention. Nursing skill mix was inversely correlated with restraint use for fall prevention and for any reason. Compared to average quarters, odds of fall prevention restraint and of any restraint were respectively 16 % (95 % CI: 3-29 %) and 18 % (95 % CI: 8-29 %) higher for quarters with very low skill mix. In this longitudinal study there was a strong negative correlation between nursing skill mix and physical restraint use. Ensuring that skill mix is consistently adequate should reduce use of restraint.

  15. Anxiolytic-like effects of restraint during the dark cycle in adolescent mice.

    Science.gov (United States)

    Ota, Yuki; Ago, Yukio; Tanaka, Tatsunori; Hasebe, Shigeru; Toratani, Yui; Onaka, Yusuke; Hashimoto, Hitoshi; Takuma, Kazuhiro; Matsuda, Toshio

    2015-05-01

    Stress during developmental stage may cause psychological morbidities, and then the studies on stress are important in adolescent rodents. Restraint is used as a common stressor in rodents and the effects of restraint during the light cycle have been studied, but those of restraint during the dark cycle have not. The present study examined the effects of restraint during the light and dark cycles on anxiety behaviors in adolescent mice. Restraint for 3h during either the light or dark cycle impaired memory function in the fear conditioning test, but did not affect locomotor activity. In the elevated plus-maze test, restraint during the dark cycle reduced anxiety-like behaviors in mice. Repeated exposure to a 3-h period dark cycle restraint for 2 weeks had a similar anxiolytic-like effect. In contrast, restraint for 3h during the light cycle produced anxiety behavior in adolescent, but not adult, mice. The light cycle stress increased plasma corticosterone levels, and elevated c-Fos expression in the prefrontal cortex, paraventricular hypothalamic nucleus, basolateral amygdala and dentate gyrus, and enhanced serotonin turnover in the hippocampus and striatum, while the dark cycle stress did not. There was no difference in the stress-mediated reduction in pentobarbital-induced sleeping time between dark and light cycle restraint. These findings suggest that the anxiolytic effect of dark cycle restraint is mediated by corticosterone, serotonin or γ-aminobutyric acid-independent mechanisms, although the anxiogenic effect of light cycle restraint is associated with changes in plasma corticosterone levels and serotonin turnover in specific brain regions.

  16. Your Laptop to the Rescue: Using the Child Language Data Exchange System Archive and CLAN Utilities to Improve Child Language Sample Analysis.

    Science.gov (United States)

    Ratner, Nan Bernstein; MacWhinney, Brian

    2016-05-01

    In this article, we review the advantages of language sample analysis (LSA) and explain how clinicians can make the process of LSA faster, easier, more accurate, and more insightful than LSA done "by hand" by using free, available software programs such as Computerized Language Analysis (CLAN). We demonstrate the utility of CLAN analysis in studying the expressive language of a very large cohort of 24-month-old toddlers tracked in a recent longitudinal study; toddlers in particular are the most likely group to receive LSA by clinicians, but existing reference "norms" for this population are based on fairly small cohorts of children. Finally, we demonstrate how a CLAN utility such as KidEval can now extract potential normative data from the very large number of corpora now available for English and other languages at the Child Language Data Exchange System project site. Most of the LSA measures that we studied appear to show developmental profiles suggesting that they may be of specifically higher value for children at certain ages, because they do not show an even developmental trajectory from 2 to 7 years of age.

  17. Idiopathic Pulmonary Hemosiderosis in a Child with Recurrent Macrophage Activation Syndrome Secondary to Systemic Juvenile Idiopathic Arthritis

    Science.gov (United States)

    Barut, Kenan; Sahin, Sezgin; Adrovic, Amra

    2017-01-01

    Macrophage activation syndrome, a severe complication of systemic juvenile idiopathic arthritis and other inflammatory diseases, represents one of the most important rheumatological emergencies. Delayed diagnosis could lead to life-threatening complications. Pulmonary hemosiderosis has been classically characterized by a triad of anemia, hemoptysis, and lung infiltrates on chest radiogram. Although the majority of patients of pulmonary hemosiderosis are considered idiopathic, secondary hemosiderosis associated with known diseases could be seen. In this case report, we aimed to present gradually increased pulmonary manifestations due to pulmonary hemosiderosis with recurrent macrophage activation syndrome attacks in a child with systemic juvenile idiopathic arthritis.

  18. System Intervention Problems in Child Sexual Abuse Investigations: The Mothers' Perspectives

    Science.gov (United States)

    Plummer, Carol A.; Eastin, Julie A.

    2007-01-01

    On learning that her child was sexually abused, a mother must interact with professionals charged with the implementation of investigations, treatment, and legal remedies. This qualitative study, based on data from three focus groups (n = 19) and open-ended survey questions (n = 40), documents mothers' experiences with these professionals. Mothers…

  19. Who cares for former child soldiers? Mental health systems of care in Sierra Leone

    NARCIS (Netherlands)

    Song, S.; van den Brink, H.; de Jong, J.

    2013-01-01

    While numerous studies on former child soldiers (FCS) have shown mental health needs, adequate services are a challenge. This study aimed to identify priorities, barriers and facilitators of mental health care for Sierra Leonean FCS. Thematic analysis was done on 24 qualitative interviews with parti

  20. The Value of Family Welfare Conferencing within the Child Protection and Welfare System

    Science.gov (United States)

    Devaney, Carmel; Byrne, Paul

    2015-01-01

    The Family Welfare Conference (FWC) is a model used within the child protection and welfare services to address concerns about the needs of children and their family's ability to respond to these needs. The FWC model operates in partnership with family members, who participate in identifying both the issues of concern and potential responses to…

  1. A Change Management, Systems Thinking, or Organizational Development Approach to the No Child Left Behind Act

    Science.gov (United States)

    Galloway, Dominique L.

    2007-01-01

    Problems with implementation of the No Child Left Behind Act (NCLB) can be assessed in light of change management theory. Viewing stakeholders collectively as a corporate entity supports employing change management strategies to make the NCLB work. Examining ways that organizational controls and change management can work together points to…

  2. Caseworkers' and Supervisors' Perceptions of Ohio's Statewide Automated Child Welfare Information System

    Science.gov (United States)

    Kochis, Shelia P.

    2013-01-01

    Children represent the future of mankind and their safety, well-being, and permanency are goals of the Department of Health and Human Services. The Department of Health and Human Services is the primary funding source for child welfare and protection in the United States; their requirements, rules, and laws must be upheld and understood by every…

  3. A Change Management, Systems Thinking, or Organizational Development Approach to the No Child Left Behind Act

    Science.gov (United States)

    Galloway, Dominique L.

    2007-01-01

    Problems with implementation of the No Child Left Behind Act (NCLB) can be assessed in light of change management theory. Viewing stakeholders collectively as a corporate entity supports employing change management strategies to make the NCLB work. Examining ways that organizational controls and change management can work together points to…

  4. One State's Systems Change Efforts to Reduce Child Care Expulsion: Taking the Pyramid Model to Scale

    Science.gov (United States)

    Vinh, Megan; Strain, Phil; Davidon, Sarah; Smith, Barbara J.

    2016-01-01

    This article describes the efforts funded by the state of Colorado to address unacceptably high rates of expulsion from child care. Based on the results of a 2006 survey, the state of Colorado launched two complementary policy initiatives in 2009 to impact expulsion rates and to improve the use of evidence-based practices related to challenging…

  5. Who cares for former child soldiers? Mental health systems of care in Sierra Leone

    NARCIS (Netherlands)

    Song, S.; van den Brink, H.; de Jong, J.

    2013-01-01

    While numerous studies on former child soldiers (FCS) have shown mental health needs, adequate services are a challenge. This study aimed to identify priorities, barriers and facilitators of mental health care for Sierra Leonean FCS. Thematic analysis was done on 24 qualitative interviews with

  6. Using Seclusion Timeout and Physical Restraint: An Analysis of State Policy, Research, and the Law

    Science.gov (United States)

    Rozalski, Michael E.; Yell, Mitchell L.; Boreson, Lynn A.

    2006-01-01

    Seclusion timeout and physical restraint are aversive procedures designed to reduce or eliminate students' serious problem behavior. Using these procedures with students in special education has become commonplace in the last decade. Nevertheless, both seclusion timeout and physical restraint procedures have been, and continue to be, quite…

  7. CCBD's Position Summary on Physical Restraint & Seclusion Procedures in School Settings

    Science.gov (United States)

    Peterson, Reece; Albrecht, Susan; Johns, Bev

    2009-01-01

    This document is a summary of policy recommendations from two longer and more detailed documents available from the Council for Children with Behavioral Disorders (CCBD) regarding the use of physical restraint and seclusion procedures in schools. These recommendations include: (1) CCBD believes that physical restraint or seclusion procedures…

  8. Suppression of Pica by Overcorrection and Physical Restraint: A Comparative Analysis.

    Science.gov (United States)

    Singh, Nirbhay N.; Bakker, Leon W.

    1984-01-01

    Each occurrence of pica (ingestion of inedible objects) in two profoundly retarded adults was followed by either overcorrection or physical restraint. Although both procedures reduced the occurrence of pica and had a similar effect on collateral behaviors, physical restraint was clinically more effective in terms of immediate response reduction.…

  9. Clinical decision making on the use of physical restraint in intensive care units

    Directory of Open Access Journals (Sweden)

    Xinqian Li

    2014-12-01

    Full Text Available Physical restraint is a common nursing intervention in intensive care units and nurses often use it to ensure patients' safety and to prevent unexpected accidents. However, existing literature indicated that the use of physical restraint is a complex one because of inadequate rationales, the negative physical and emotional effects on patients, but the lack of perceived alternatives. This paper is aimed to interpret the clinical decision-making theories related to the use of physical restraint in intensive care units in order to facilitate our understanding on the use of physical restraint and to evaluate the quality of decisions made by nurses. By reviewing the literature, intuition and heuristics are the main decision-making strategies related to the use of physical restraint in intensive care units because the rapid and reflexive nature of intuition and heuristics allow nurses to have a rapid response to urgent and emergent cases. However, it is problematic if nurses simply count their decision-making on experience rather than incorporate research evidence into clinical practice because of inadequate evidence to support the use of physical restraint. Besides that, such a rapid response may lead nurses to make decisions without adequate assessment and thinking and therefore biases and errors may be generated. Therefore, despite the importance of intuition and heuristics in decision-making in acute settings on the use of physical restraint, it is recommended that nurses should incorporate research evidence with their experience to make decisions and adequate assessment before implementing physical restraint is also necessary.

  10. Physical Restraint of Students with Behavior Disorders in Day Treatment and Residential Settings

    Science.gov (United States)

    Fogt, Julie B.; George, Michael P.; Kern, Lee; White, George P.; George, Nancy L.

    2008-01-01

    This study explored administrators' attitudes about the use of physical restraint in their school settings. Administrators of day treatment and residential programs for elementary students with emotional and behavioral disorders in the Mid-Atlantic states were surveyed on their attitudes toward, and the use of, physical restraint within their…

  11. CCBD's Position Summary on the Use of Physical Restraint Procedures in School Settings

    Science.gov (United States)

    Peterson, Reece; Albrecht, Susan; Johns, Bev

    2009-01-01

    This document provides policy recommendations of the Council for Children with Behavioral Disorders regarding the use of physical restraint procedures in schools. It includes (a) an introduction, (b) a declaration of principles, and (c) recommendations regarding the use of physical restraint in school settings. Explanation or elaboration of…

  12. Physical Restraint in Residential Childcare: The Experiences of Young People and Residential Workers

    Science.gov (United States)

    Steckley, Laura; Kendrick, Andrew

    2008-01-01

    There have long been concerns about the use of physical restraint in residential care. This article presents the findings of a qualitative study that explores the experiences of children, young people and residential workers of physical restraint. The research identifies the dilemmas and ambiguities for both staff and young people, and…

  13. Effects of Physical Restraint on the Behavior of Hyperactive Mentally Retarded Persons.

    Science.gov (United States)

    Singh, Nirbhay N.; And Others

    1984-01-01

    Each instance of out-of-seat behavior of four hyperactive moderately/severely mentally retarded eight and nine year olds resulted in return to seat followed by 15-second physical restraint. Out-of-seat behavior of all four Ss increased during two implementations of the restraint contingency compared to levels during alternative baseline periods.…

  14. Prior Restraint in High School: Does It Violate Students' First Amendment Rights?

    Science.gov (United States)

    Trager, Robert E.

    The Supreme Court of the United States has issued three significant rulings on the question of prior restraint by government officials of material to be published in print media. Each time it ruled that only in exceptional circumstances will prior restraint be permitted. Lower federal courst have not taken the same view regarding prior restraint…

  15. The Association for Behavior Analysis International Position Statement on Restraint and Seclusion

    Science.gov (United States)

    Vollmer, Timothy R.; Hagopian, Louis P.; Bailey, Jon S.; Dorsey, Michael F.; Hanley, Gregory P.; Lennox, David; Riordan, Mary M.; Spreat, Scott

    2011-01-01

    A task force authorized by the Executive Council of the Association for Behavior Analysis International (ABAI) generated the statement below concerning the techniques called "restraint" and "seclusion." Members of the task force independently reviewed the scientific literature concerning restraint and seclusion and agreed unanimously to the…

  16. 28 CFR 552.26 - Medical attention in use of force and application of restraints incidents.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Medical attention in use of force and application of restraints incidents. 552.26 Section 552.26 Judicial Administration BUREAU OF PRISONS... § 552.26 Medical attention in use of force and application of restraints incidents. (a) In immediate...

  17. Growth and Predictors of Growth Restraint in Moderately Preterm Children Aged 0 to 4 Years

    NARCIS (Netherlands)

    Bocca-Tjeertes, I.F.; Kerstjens, J.M.; Reijneveld, S.A.; de Winter, A.F.; Bos, A.F.

    2011-01-01

    OBJECTIVE: To describe growth in moderately preterm-born children, determine the prevalence of growth restraint at the age of 4, and identify predictors of growth restraint. We hypothesized that growth in moderately preterm-born children differs from growth in term-born children and that growth rest

  18. Are Dietary Restraint Scales Valid Measures of Acute Dietary Restriction? Unobtrusive Observational Data Suggest Not

    Science.gov (United States)

    Stice, Eric; Fisher, Melissa; Lowe, Michael R.

    2004-01-01

    The finding that dietary restraint scales predict onset of bulimic pathology has been interpreted as suggesting that dieting causes this eating disturbance, despite the dearth of evidence that these scales are valid measures of dietary restriction. The authors conducted 4 studies that tested whether dietary restraint scales were inversely…

  19. As time goes by: reasons and characteristics of prolonged episodes of mechanical restraint in forensic psychiatry.

    Science.gov (United States)

    Gildberg, Frederik A; Fristed, Peter; Makransky, Guido; Moeller, Elsebeth H; Nielsen, Lea D; Bradley, Stephen K

    2015-01-01

    Evidence suggests the prevalence and duration of mechanical restraint are particularly high among forensic psychiatric inpatients. However, only sparse knowledge exists regarding the reasons for, and characteristics of, prolonged use of mechanical restraint in forensic psychiatry. This study therefore aimed to investigate prolonged episodes of mechanical restraint on forensic psychiatric inpatients. Documentary data from medical records were thematically analyzed. Results show that the reasons for prolonged episodes of mechanical restraint on forensic psychiatric inpatients can be characterized by multiple factors: "confounding" (behaviors associated with psychiatric conditions, substance abuse, medical noncompliance, etc.), "risk" (behaviors posing a risk for violence), and "alliance parameters" (qualities of the staff-patient alliance and the patients' openness to alliance with staff), altogether woven into a mechanical restraint spiral that in itself becomes a reason for prolonged mechanical restraint. The study also shows lack of consistent clinical assessment during periods of restraint. Further investigation is indicated to develop an assessment tool with the capability to reduce time spent in mechanical restraint.

  20. The story behind the Dutch model: the consensual politics of wage restraint

    NARCIS (Netherlands)

    Hendriks, C.

    2011-01-01

    The idea of wage restraint has a long history in the Netherlands and has been presented as the recipe for economic recovery for many years now. In times of economic (and political) crisis, wage restraint has been the standard response of the Dutch government, often in cooperation with unions and emp

  1. Dieting, Dietary Restraint, and Binge Eating Disorder among Overweight Adolescents in Turkey

    Science.gov (United States)

    Bas, Murat; Bozan, Nuray; Cigerim, Nevin

    2008-01-01

    The purpose of this study was to determine the relationship among dieting, dietary restraint, disinhibition, hunger, and binge eating among overweight adolescent girls. Participants were 743 overweight adolescent girls between 16 and 19 years of age. The mean BMI was 24.9 [+ or -] 0.8 kg/[m[superscript 2] in the low-restraint group and 25.1 [+ or…

  2. Dieting, Dietary Restraint, and Binge Eating Disorder among Overweight Adolescents in Turkey

    Science.gov (United States)

    Bas, Murat; Bozan, Nuray; Cigerim, Nevin

    2008-01-01

    The purpose of this study was to determine the relationship among dieting, dietary restraint, disinhibition, hunger, and binge eating among overweight adolescent girls. Participants were 743 overweight adolescent girls between 16 and 19 years of age. The mean BMI was 24.9 [+ or -] 0.8 kg/[m[superscript 2] in the low-restraint group and 25.1 [+ or…

  3. Suppression of Pica by Overcorrection and Physical Restraint: A Comparative Analysis.

    Science.gov (United States)

    Singh, Nirbhay N.; Bakker, Leon W.

    1984-01-01

    Each occurrence of pica (ingestion of inedible objects) in two profoundly retarded adults was followed by either overcorrection or physical restraint. Although both procedures reduced the occurrence of pica and had a similar effect on collateral behaviors, physical restraint was clinically more effective in terms of immediate response reduction.…

  4. Short-term effects of an educational intervention on physical restraint use: a cluster randomized trial

    Directory of Open Access Journals (Sweden)

    Gulpers Math JM

    2006-10-01

    Full Text Available Abstract Background Physical restraints are still frequently used in nursing home residents despite growing evidence for the ineffectiveness and negative consequences of these methods. Therefore, reduction in the use of physical restraints in psycho-geriatric nursing home residents is very important. The aim of this study was to investigate the short-term effects of an educational intervention on the use of physical restraints in psycho-geriatric nursing home residents. Methods A cluster randomized trial was applied to 5 psycho-geriatric nursing home wards (n = 167 residents with dementia. The wards were assigned at random to either educational intervention (3 wards or control status (2 wards. The restraint status was observed and residents' characteristics, such as cognitive status, were determined by using the Minimum Data Set (MDS at baseline and 1 month after intervention. Results Restraint use did not change significantly over time in the experimental group (55%–56%, compared to a significant increased use (P Conclusion An educational programme for nurses combined with consultation with a nurse specialist did not decrease the use of physical restraints in psycho-geriatric nursing home residents in the short term. However, the residents in the control group experienced more restraint use during the study period compared to the residents in the experimental group. Whether the intervention will reduce restraint use in the long term could not be inferred from these results. Further research is necessary to gain insight into the long-term effects of this educational intervention.

  5. Comparison of chemical restraint techniques in ostrich (Struthio camelus

    Directory of Open Access Journals (Sweden)

    R Ciboto

    2006-06-01

    Full Text Available Chemical restraint in ostriches is usually required for short-time interventions. Thus, this study established and evaluated intravenous anesthetics formulated from commonly used drugs in order to accomplish total restraint on this species and allow painful procedures to be performed. Thirty male and female ostriches weighing from 40 to 90 kg were randomly distributed into five groups. Animals in Groups I, II and III were given acepromazine (0.25 mg/kg i.m. and those in Groups IV and V were given xylazine (1.0 mg/kg i.m.. The following drugs were administered intravenously 15 to 20 min later: Group I - propofol (4.0 mg/kg, Groups II and IV - ketamine (5.0 mg/kg and diazepam (0.25 mg/kg, Groups III and V - tiletamine-zolazepam (3.0 mg/kg. All protocols have produced satisfactory results regarding total containment, muscular relaxation and maintenance of the evaluated parameters within a normal range.

  6. Different subtypes of impulsivity differentiate uncontrolled eating and dietary restraint.

    Science.gov (United States)

    Leitch, Margaret A; Morgan, Michael J; Yeomans, Martin R

    2013-10-01

    The current study explored the relationship between three subtypes of impulsivity (Reflection Impulsivity, Impulsive Choice, and Impulsive Action) and measures of uncontrolled eating (TFEQ-D) and restraint (TFEQ-R). Eighty women classified as scoring higher or lower on TFEQ-D and TFEQ-R completed the Matching Familiar Figures Test (MFFT20), Delay Discounting Task (DDT), a Go No Go task, Balloon Analogue Risk Task (BART), and the Barrett Impulsivity Scale-11 (BIS-11). To test whether these relationships were affected by enforced controls overeating, half of the participants fasted the night before and ate breakfast in the laboratory before testing and half had no such control. Women scoring higher on the TFEQ-D were significantly more impulsive on the MFFT20 and BIS-11 overall but not on DDT, Go No Go or BART. Women scoring higher on TFEQ-R were significantly less impulsive on the Go No Go task but did not differ on other measures. The eating manipulation modulated responses on the BART and BIS-11 non-planning scale depending on TFEQ-D classification. These results confirm recent data that high scores on TFEQ-D are related to impulsivity, but imply this relates more to Reflection Impulsivity rather than Impulsive Choice or Action. In contrast restrained eating was associated with better inhibitory control. Taken together, these results suggest that subtypes of impulsivity further differentiate uncontrolled eating and restraint, and suggest that a poor ability to reflect on decisions may underlie some aspects of overeating.

  7. Influence of Polymer Restraint on Ballistic Performanceof Alumina Ceramic Tiles

    Directory of Open Access Journals (Sweden)

    P.R.S. Reddy

    2008-03-01

    Full Text Available An experimental study has been carried out to evaluate the influence of confinement ofalumina ceramic tiles through polymer restraint, on its ballistic performance. Tiles of 99.5 per centpurity alumina were subjected to ballistic impact against 7.62 mm armour piercing projectiles atvelocities of about 820 m/s. The tiles of size 75 mm x 75 mm x 7 mm were confined on both facesby effectively bonding varying numbers of layers of polymer fabrics. These were then bondedto a 10 mm thick fibre glass laminate as a backing using epoxy resin. High performance polyethyleneand aramid polymer fabrics were used in the current set of experiments for restraining the tiles.Comparative effects of confinement on energy absorption of tiles with varied number of layersof fabrics were evaluated. It was observed that by providing effective confinement to the tile,energy absorption could be doubled with increase in areal density by about 13 per cent.Photographs of the damage and the effects of restraint on improvement in energy absorptionof ceramic tiles are presented and discussed.

  8. Plasma cortisol levels in captive wild felines after chemical restraint

    Directory of Open Access Journals (Sweden)

    G.P. Nogueira

    1997-11-01

    Full Text Available Eight Panthera onca (Po, 13 Felis concolor (Fc, 7 Felis yagouaroundi (Fy, 7 Felis tigrina (Ft and 5 Felis pardalis (Fp specimens from São Paulo State zoos were used. All animals were restrained with darts containing 10 mg/kg ketamine and 1 mg/kg xylazine. Venous blood samples were collected as soon as possible (within 15-20 min and serum was frozen until the time for cortisol quantification. Cortisol was determined using a solid phase radioimmunoassay with an intra-assay coefficient of 8.51%. Data were analyzed statistically by the Kruskal-Wallis test, followed by Dunn's multiple comparisons test, and the one-sample t-test, with the level of significance set at P<0.05. Data are reported as means ± SEM. Cortisol levels differed among the captive felines: Po = 166 ± 33a, Fc = 670 ± 118b, Fy = 480 ± 83b, Ft = 237 ± 42ab, Fp = 97 ± 12a nmol/l (values followed by different superscript letters were significantly different (P<0.001. Since most of the veterinary procedures on these species involve chemical restraint, these results show the necessity of preventive measures in order to minimize the effect of restraint stress on more susceptible species

  9. Assistive technology in occupational therapy practice with a child with degenerative disease of the central nervous system

    Directory of Open Access Journals (Sweden)

    Tácia Caroline de Lima Rodrigues

    2015-07-01

    Full Text Available This paper aims to report the effects of the interventions, using the resource of assistive technology, carried out with a child with degenerative disease of the central nervous system at his home. This is a study case, which was conducted in seven meetings, addressing the child and his caregivers during a process of evaluation, preparation of assistive devices, family orientation, and evaluation of the family environment repercussion. The results showed that the child presents significant motor, cognitive, and psychosocial impairments, resulting in difficulties in performing activities of daily living, communication, and play. Adjustments were proposed to facilitate the child’s involvement and alleviate family difficulties on equipment and environments, such as wheelchair, bedroom, bathroom, orthosis, toys and communication. Finally, it was possible to note that the assistive technology resources were used according to the child’s needs and his own reality, and that the domiciliary visits contributed positively to the family’s life because they facilitated the child’s care, despite the limitations faced.

  10. Quality of Health Management Information System for Maternal & Child Health Care in Haryana State, India

    Science.gov (United States)

    Sharma, Atul; Rana, Saroj Kumar; Prinja, Shankar; Kumar, Rajesh

    2016-01-01

    Background Despite increasing importance being laid on use of routine data for decision making in India, it has frequently been reported to be riddled with problems. Evidence suggests lack of quality in the health management information system (HMIS), however there is no robust analysis to assess the extent of its inaccuracy. We aim to bridge this gap in evidence by assessing the extent of completeness and quality of HMIS in Haryana state of India. Methods Data on utilization of key maternal and child health (MCH) services were collected using a cross-sectional household survey from 4807 women in 209 Sub-Centre (SC) areas across all 21 districts of Haryana state. Information for same services was also recorded from HMIS records maintained by auxiliary nurse midwives (ANMs) at SCs to check under- or over-recording (Level 1 discordance). Data on utilisation of MCH services from SC ANM records, for a subset of the total women covered in the household survey, were also collected and compared with monthly reports submitted by ANMs to assess over-reporting while report preparation (Level 2 discordance) to paint the complete picture for quality and completeness of routine HMIS. Results Completeness of ANM records for various MCH services ranged from 73% for DPT1 vaccination dates to 94.6% for dates of delivery. Average completeness level for information recorded in HMIS was 88.5%. Extent of Level 1 discordance for iron-folic acid (IFA) supplementation, 3 or more ante-natal care (ANC) visits and 2 Tetanus toxoid (TT) injections was 41%, 16% and 2% respectively. In 48.2% cases, respondents from community as well as HMIS records reported at least one post-natal care (PNC) home visit by ANM. Extent of Level 2 discordance ranged from 1.6% to 6%. These figures were highest for number of women who completed IFA supplementation, contraceptive intra-uterine device insertion and provision of 2nd TT injection during ANC. Conclusions HMIS records for MCH services at sub-centre level

  11. The Nature and Extent of Physical Restraint-Related Deaths in Nursing Homes: A Systematic Review.

    Science.gov (United States)

    Bellenger, Emma N; Ibrahim, Joseph E; Lovell, Janaka Jonathan; Bugeja, Lyndal

    2017-05-01

    The aim of this study is to conduct a systematic review of the published research to examine the extent, nature, and risk factors of mortality due to physical restraint use. In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement, this review examined all peer-reviewed studies published in English describing mortality due to physical restraint in nursing home residents. The combined searches yielded 2,016 records of which eight articles were eligible for inclusion. There were 174 deaths due to physical restraint in nursing home residents across the eight studies. Neck compression ( n = 8) was the most common mechanism of harm resulting in death due to mechanical asphyxia. Physical restraint is associated with deaths in nursing home residents. Further research is needed to investigate alternative interventions to restraint use.

  12. Education on physical restraint reduction in dementia care: a review of the literature.

    Science.gov (United States)

    De Bellis, A; Mosel, K; Curren, D; Prendergast, J; Harrington, A; Muir-Cochrane, E

    2013-01-01

    Dementia is a priority area for all countries as populations age and dementia prevalence increases. The use of physical restraint is a possible clinical practice for persons with dementia across settings when behaviours indicate a perceived need. Indeed, this may be the first choice in practice, occurring in part because of lack of education, safety concerns, perceived costs and staffing issues. This article reviews the literature on the issues surrounding, and use of, physical restraint for people with dementia, highlighting the rationales for use and the benefits and barriers to physical restraint. Recommendations include the importance of education and policy to reduce or eliminate physical restraint of persons with dementia to overcome identified barriers at the individual, cultural and organizational levels. An educational programme from the literature review is proposed specific to the reduction or elimination of physical restraint.

  13. Use of physical restraint in nursing homes: clinical‐ethical considerations

    Science.gov (United States)

    Gastmans, C; Milisen, K

    2006-01-01

    This article gives a brief overview of the state of the art concerning physical restraint use among older persons in nursing homes. Within this context we identify some essential values and norms that must be observed in an ethical evaluation of physical restraint. These values and norms provide the ethical foundation for a number of concrete recommendations that could give clinical and ethical support to caregivers when they make decisions about physical restraint. Respect for the autonomy and overall wellbeing of older persons, a proportional assessment of the advantages and disadvantages, a priority focus on the alternatives to physical restraint, individualised care, interdisciplinary decision making, and an institutional policy are the central points that make it possible to deal responsibly with the use of physical restraint for older persons in nursing homes. PMID:16507658

  14. Use of physical restraint in nursing homes: clinical-ethical considerations.

    Science.gov (United States)

    Gastmans, C; Milisen, K

    2006-03-01

    This article gives a brief overview of the state of the art concerning physical restraint use among older persons in nursing homes. Within this context we identify some essential values and norms that must be observed in an ethical evaluation of physical restraint. These values and norms provide the ethical foundation for a number of concrete recommendations that could give clinical and ethical support to caregivers when they make decisions about physical restraint. Respect for the autonomy and overall wellbeing of older persons, a proportional assessment of the advantages and disadvantages, a priority focus on the alternatives to physical restraint, individualised care, interdisciplinary decision making, and an institutional policy are the central points that make it possible to deal responsibly with the use of physical restraint for older persons in nursing homes.

  15. Exploring the use of seclusion and restraint with deaf psychiatric patients: comparisons with hearing patients.

    Science.gov (United States)

    Diaz, David R; Landsberger, Sarah A

    2010-12-01

    Archival data of seclusion and restraint events in a group of deaf adults (n = 30) was compared with a random sample of hearing adults with intellectual disabilities (ID) (n = 30) and a random sample of hearing adults without ID (n = 51) admitted to a state hospital from 1998 to 2008. Only 12% of the hearing non-ID group experienced a seclusion or restraint versus 43% of the deaf group. The ID group also showed significantly higher rates of seclusion and restraint than the hearing non-ID group (30 vs. 12%). Patients in the deaf and ID group were significantly more likely to be diagnosed with impulse control disorders (23 and 23%, respectively), which may have contributed to the higher utilization of seclusion and restraint procedures in these groups. Deafness-related cultural and linguistic variables that impact the use of seclusion and restraint are reviewed.

  16. ROLE OF D2 DOPAMINE RECEPTOR ON MODULATION OF THE LEUKOCYTE FORMULA IN RESTRAINT STRESSED RATS

    Directory of Open Access Journals (Sweden)

    Lucian Hritcu

    2006-08-01

    Full Text Available Dopamine is a monoamine neurotransmitter of both central and peripheral nervous system. Its role in the neural-immune communication has been discussed in the present study. Results reveal that in vivo blockade of D2 dopamine receptor by means of sulpiride, a selective antagonist for D2 dopamine receptor produce changes in functional activities of the immune effector cells. Adults rats pretreated once with LPS (a bacterial product (25µg/250µl, i.p., produce an immune response, were subjected to i.p. injection with sulpiride (4 mg/kg b.w., i.p., a selective antagonist for D2 dopamine receptors, after 3 days postimmunization. After 18 days later, we assessed the total leukocyte number, neutrophils, eosinophils and basophils number. In summary, we provide that D2 dopamine receptor blockade suppress or enhance the immune effector cells number in restraint stress.

  17. Metatraits of the Big Five differentially predict engagement and restraint of behavior.

    Science.gov (United States)

    Hirsh, Jacob B; Deyoung, Colin G; Peterson, Jordan B

    2009-08-01

    Although initially believed to contain orthogonal dimensions, the Big Five personality taxonomy appears to have a replicable higher-order structure, with the metatrait of Plasticity reflecting the shared variance between Extraversion and Openness/Intellect, and the metatrait of Stability reflecting the shared variance among Neuroticism, Agreeableness, and Conscientiousness. These higher order traits have been theorized to relate to individual differences in the functioning of the dopamine and serotonin systems, respectively. As dopamine is associated with exploration and incentive-related action, and serotonin with satiety and constraint, this neuropharmacological trait theory has behavioral implications, which we tested in 307 adults by examining the association of a large number of behavioral acts with multi-informant reports of the metatraits. The frequencies of acts were consistently positively correlated with Plasticity and negatively correlated with Stability. At the broadest level of description, variation in human personality appears to reflect engagement and restraint of behavior.

  18. Moving beyond resistance to restraint minimization: a case study of change management in aged care.

    Science.gov (United States)

    Johnson, Susan; Ostaszkiewicz, Joan; O'Connell, Beverly

    2009-01-01

    This case study describes a quality initiative to minimize restraint in an Australian residential aged care facility. The process of improving practice is examined with reference to the literature on implementation of research into practice and change management. The differences between planned and emergent approaches to change management are discussed. The concepts of resistance and attractors are explored in relation to our experiences of managing the change process in this initiative. The importance of the interpersonal interactions that were involved in facilitating the change process is highlighted. Recommendations are offered for dealing with change management processes in clinical environments, particularly the need to move beyond an individual mind-set to a systems-based approach for quality initiatives in residential aged care.

  19. Real time control of restraint systems in frontal crashes

    NARCIS (Netherlands)

    Griotto, G.; Lemmen, P.P.M.; Eijnden, E.A.C. van den; Leijsen, A.C.P. van; Schie, C. van; Cooper, J.

    2007-01-01

    It is generally accepted that the targets for fatality reduction in car accidents set by Governments in Europe, USA and Japan can only be met by using advanced technologies that will include a broad range of sensors to monitor the crash likelihood and severity, vehicle condition, occupant type and

  20. Strategies to increase the use of restraint systems : background paper.

    NARCIS (Netherlands)

    Mäkinen, T. & Hagenzieker, M.P.

    1992-01-01

    Strategies to increase the use of seat belts are mainly dealt with. Safety belt use trends on front seats inside and outside urban areas are presented for Germany, Great Britain, The Netherlands, Finland, France and Canada, in the period 1972-1990. In many countries, a number of countermeasures has

  1. 49 CFR 213.110 - Gage restraint measurement systems.

    Science.gov (United States)

    2010-10-01

    ... test will not be considered valid until contact with these components is restored under static loading... applying an increasing lateral force from 0 to 4,000 pounds on the web/base fillet of each rail...

  2. Chronic orthostatic and antiorthostatic restraint induce neuroendocrine, immune and neurophysiological disorders in rats

    Science.gov (United States)

    Assenmacher, I.; Mekaouche, M.; Maurel, D.; Barbanel, G.; Givalois, L.; Boissin, J.; Malaval, F.; Ixart, G.

    The tail-cast suspension rat model has been developed in ground laboratories interested in space physiology for extensive study of mechanisms causing the pathophysiological syndrome associated with space flights. We used individually-caged male rats to explore the effects of acute and chronic (7d) orthostatic restraint (OR) and head-down anti-orthostatic restraint (AOR) on a series of physiological variables. The acute restraint study showed that (1) the installation of the OR device induced an acute reaction for 2 days, with a substantial rise in ACTH (x2) and CORT (x6), and that (2) the head-down tilt from OR to AOR induced (i) within 10 min and lasting 60 min a 2-fold rise in the intra-cerebro-ventricular pressure (Picv) monitored with an icv telemetric recording system, which receded to normal between 60 and 120 min; and (ii) within 30 min a short-lived 4-fold rise in plasma ACTH and CORT levels. Chronic OR induced (1) the suppression of the diurnal ACTH/CORT rhythm, with increased mean levels, especially for ACTH, (2) a degraded circadian locomotor activity rhythm manifested by a significant reduction in the spectral power of the 24h periodicity and a concomitant emergence of shorter (ultradian) periodicities, (3) an associated, but less pronounced alteration of the diurnal rhythm in body temperature; and (4) a marked increase in baseline plasma levels of IL-1β and an increased reactivity in cytokine release following an E. coli endotoxin (LPS) challenge. AOR induced (1) a similar obliteration of the circadian ACTH/CORT rhythm, (2) the loss of close correlation between ACTH and CORT, (3) a generalized increase in baseline plasma IL-1β levels and (4) more extensive degradation of the arcadian periodicity for both locomotor activity and, to a lesser extent, body temperature, replaced by dominant spectral powers for ultradian periodicities (3 to 10h). In conclusion, both experimental paradigms — but AOR more than OR — caused a blockade of the arcadian

  3. Characteristics of nursing home residents and physical restraint: a systematic literature review.

    Science.gov (United States)

    Hofmann, Hedi; Hahn, Sabine

    2014-11-01

    To analyse and to summarise factors associated with nursing home residents' characteristics which could lead to physical restraint, and to investigate the consequences of physical restraint use for this population. Even though the application of physical restraint is highly controversial, prevalence rates show that it is a common intervention in nursing homes. Residents' characteristics seem to be important to predict the use of physical restraint. Evidence suggests that restrained nursing home residents may have physical and psychological disadvantages as a consequence of being restrained. A systematic literature research involving the databases PubMed, Cumulative Index to Nursing and Allied Health Literature, ISI Web of Science and Cochrane Library was carried out for articles published from January 2005-November 2011. Nine Studies fulfilled the inclusion criteria and the quality assessment. Restrained residents had low activities of daily living (ADL) scores and severe cognitive impairment. Residents with low cognitive status and serious mobility impairments were at high risk to be restrained, as well as residents with previous fall and/or fracture. Repeated verbal and physical agitation was found to be positively associated with restraint use. Possible consequences of physical restraint were as follows: lower cognitive and ADL performance, higher walking dependence, furthermore falls, pressure ulcers, urinary and faecal incontinence. This systematic literature review reveals notable resident-related factors for physical restraint use. The consequences of restraint seem to negatively influence residents' physical and psychological well-being. Physical restraint seems to be an important risk factor for residents' further health problems. Resident's characteristics appear to be decisive factors for the use of physical restraint. Nurses need a high level of expertise and competence in evaluating the individual residents' situation and deciding further steps, with

  4. Assessment of a head support system to prevent pediatric out-of-position: an observational study.

    Science.gov (United States)

    Lopez-Valdes, Francisco J; Forman, Jason L; Ash, Joseph H; Kent, Richard; Alba, Juan J; Segui-Gomez, Maria

    2013-01-01

    Head injuries are the most common severe injuries sustained by pediatric occupants in road traffic crashes. Preventing children from adopting positions that can result in an increased injury risk due to unfavorable interactions with the restraints is fundamental. The objective of this paper was to assess the effect of a head support system (SS) on the lateral position of the head, the vertical position of the sternum and the shoulder belt fit. Thirty pediatric rear-seat passengers were exposed to two 75-minute trials. Volunteers were restrained by a three-point belt and, if needed, used the appropriate child restraint system for their anthropometry (high-back booster, low-back booster, no booster). A case crossover study was designed in which the volunteers used the head support system (SS) during one of the trials, acting as their own controls (No SS) in the other. Compared to the control group, the head support reduced significantly the 90(th) percentile value of the absolute value of the relative lateral motion of the head, regardless of the restraint used. The system also reduced the maximum downward position of the sternal notch within the low-back booster group. As for the belt fit, the use of the head support improved significantly the position of the shoulder belt on the occupant in the low-back booster and in the no booster groups.

  5. Assessment of a head support system to prevent pediatric out-of-position: an observational study

    Science.gov (United States)

    Lopez-Valdes, Francisco J.; Forman, Jason L.; Ash, Joseph H.; Kent, Richard; Alba, Juan J.; Segui-Gomez, Maria

    2013-01-01

    Head injuries are the most common severe injuries sustained by pediatric occupants in road traffic crashes. Preventing children from adopting positions that can result in an increased injury risk due to unfavorable interactions with the restraints is fundamental. The objective of this paper was to assess the effect of a head support system (SS) on the lateral position of the head, the vertical position of the sternum and the shoulder belt fit. Thirty pediatric rear-seat passengers were exposed to two 75-minute trials. Volunteers were restrained by a three-point belt and, if needed, used the appropriate child restraint system for their anthropometry (high-back booster, low-back booster, no booster). A case crossover study was designed in which the volunteers used the head support system (SS) during one of the trials, acting as their own controls (No SS) in the other. Compared to the control group, the head support reduced significantly the 90th percentile value of the absolute value of the relative lateral motion of the head, regardless of the restraint used. The system also reduced the maximum downward position of the sternal notch within the low-back booster group. As for the belt fit, the use of the head support improved significantly the position of the shoulder belt on the occupant in the low-back booster and in the no booster groups. PMID:24406966

  6. Human Modeling Evaluations in Microgravity Workstation and Restraint Development

    Science.gov (United States)

    Whitmore, Mihriban; Chmielewski, Cynthia; Wheaton, Aneice; Hancock, Lorraine; Beierle, Jason; Bond, Robert L. (Technical Monitor)

    1999-01-01

    The International Space Station (ISS) will provide long-term missions which will enable the astronauts to live and work, as well as, conduct research in a microgravity environment. The dominant factor in space affecting the crew is "weightlessness" which creates a challenge for establishing workstation microgravity design requirements. The crewmembers will work at various workstations such as Human Research Facility (HRF), Microgravity Sciences Glovebox (MSG) and Life Sciences Glovebox (LSG). Since the crew will spend considerable amount of time at these workstations, it is critical that ergonomic design requirements are integral part of design and development effort. In order to achieve this goal, the Space Human Factors Laboratory in the Johnson Space Center Flight Crew Support Division has been tasked to conduct integrated evaluations of workstations and associated crew restraints. Thus, a two-phase approach was used: 1) ground and microgravity evaluations of the physical dimensions and layout of the workstation components, and 2) human modeling analyses of the user interface. Computer-based human modeling evaluations were an important part of the approach throughout the design and development process. Human modeling during the conceptual design phase included crew reach and accessibility of individual equipment, as well as, crew restraint needs. During later design phases, human modeling has been used in conjunction with ground reviews and microgravity evaluations of the mock-ups in order to verify the human factors requirements. (Specific examples will be discussed.) This two-phase approach was the most efficient method to determine ergonomic design characteristics for workstations and restraints. The real-time evaluations provided a hands-on implementation in a microgravity environment. On the other hand, only a limited number of participants could be tested. The human modeling evaluations provided a more detailed analysis of the setup. The issues identified

  7. [Psychotherapeutically-Systemic Acting in the Integrated Family Counseling Presented by the Example of Child-Centered Educational Counseling].

    Science.gov (United States)

    Herrmann, Ines

    2015-01-01

    The article gives an insight into the practice of Integrated Family Counseling and identifies their interfaces with psychotherapeutic approaches. The example of the child-centered educational counseling shows how consultancy, systemic and psychotherapeutic interventions interact in order to meet the parents educational needs defined by the parents. The first part of the article explains the term of Integrated Family Counseling, differentiates the various substantive areas of work and outlines the systematic attitude. The second part describes the psychotherapy-systemic action in the child-centered educational counseling from the perspective of the practice. Main priorities in the course of counseling, including cause-related behavioral and developmental diagnostics, play therapy intervention and parental involvement are presented. Here the systemic approach, major methodological elements as well as their effects are pointed up. The third part is devoted to the reflection of the relationship between counseling and psychotherapy. It becomes clear that in particular the intended effectiveness of an intervention determines their methodological design to a large extent.

  8. Do organisational constraints explain the use of restraint? A comparative ethnographic study from three nursing homes in Norway.

    Science.gov (United States)

    Øye, Christine; Jacobsen, Frode Fadnes; Mekki, Tone Elin

    2017-07-01

    To investigate (1) what kind of restraint is used in three nursing homes in Norway and (2) how staff use restraint under what organisational conditions. Restraint use in residents living with dementia in nursing homes is controversial, and at odds with fundamental human rights. Restraint is a matter of hindering residents' free movement and will by applying either interactional, physical, medical, surveillance or environmental restraint. Previous research has identified use of restraint related to individual resident characteristics such as agitation, aggressiveness and wandering. This model is embedded in an overall mixed-method education intervention design study called Modelling and evaluating evidence-based continuing education program in dementia care (MEDCED), applying ethnography postintervention to examine the use of restraint in 24 nursing homes in Norway. Based on restraint diversity measured in the trial, ethnographic investigation was carried out in three different nursing homes in Norway over a 10-month period to examine restraint use in relation to organisational constraints. Several forms of restraint were observed; among them, interactional restraint was used most frequently. We identified that use of restraint relates to the characteristics of individual residents, such as agitation, aggressiveness and wandering. However, restraint use should also be explained in relation to organisational conditions such as resident mix, staff culture and available human resources. A fluctuating and dynamic interplay between different individual and contextual factors determines whether restraint is used - or not in particular situations with residents living with dementia. Educational initiatives targeting staff to reduce restraint must be sensitive towards fluctuating organisational constraints. © 2016 John Wiley & Sons Ltd.

  9. USING ADDIE MODEL TO DESIGN EARLY DETECTION SYSTEM OF CHILD GROWTH AND DEVELOPMENT IN THE COMMUNITY HEALTH CENTER OF BENDOSARI, SEMARANG INDONESIA

    Directory of Open Access Journals (Sweden)

    Liliana Nur Kholifah

    2017-07-01

    Full Text Available To reduce the increase of the impaired child grwoth and development, early detection system is needed. The system designed based on information technology will facilitate the health personnels to achieve the desired outcome. In this study, The Early Detection System was developed using ADDIE (Analysis, Design, Development, Implementation, and Evaluation instruction model. The evaluation showed that the Early Detection System was effective in terms of completeness (7.2, ease (13.60, timeliness (7.60, accuracy (17.10, and conformity (8.00. This innovation is expected to contribute positively for child growth and development in Indonesia

  10. Mental Health Nursing, Mechanical Restraint Measures and Patients’ Legal Rights

    DEFF Research Database (Denmark)

    Birkeland, Søren; Gildberg, Frederik Alkier

    2016-01-01

    Abstract: Coercive mechanical restraint (MR) in psychiatry constitute the perhaps most important exception from the common health law requirement for involving patients in health care decisions and achieving their informed consent prior to treatment. Coercive measures and particularly MR constitute...... a serious collision with patient autonomy principles, pose a particular challenge to psychiatric patients’ legal rights, and put intensified demands on health professional performance. Legal rights principles require rationale for coercive measure use be thoroughly considered and rigorously documented......’ rights call for taking notice of patient evaluations. Consequently, if it comes out that psychiatric staff failed to pay appropriate consideration for the patient’s mental state, perspective, and expressions, patient response deviations are to be judicially interpreted in this light potentially rendering...

  11. Mental Health Nursing, Mechanical Restraint Measures and Patients’ Legal Rights

    DEFF Research Database (Denmark)

    Birkeland, Søren; Gildberg, Frederik Alkier

    2016-01-01

    a serious collision with patient autonomy principles, pose a particular challenge to psychiatric patients’ legal rights, and put intensified demands on health professional performance. Legal rights principles require rationale for coercive measure use be thoroughly considered and rigorously documented......Abstract: Coercive mechanical restraint (MR) in psychiatry constitute the perhaps most important exception from the common health law requirement for involving patients in health care decisions and achieving their informed consent prior to treatment. Coercive measures and particularly MR constitute....... This article presents an in-principle Danish Psychiatric Complaint Board decision concerning MR use initiated by untrained staff. The case illustrates that, judicially, weight must be put on the patient perspective on course of happenings and especially when health professional documentation is scant, patients...

  12. Seclusion room vs. physical restraint in an adolescent inpatient setting: patients' attitudes.

    Science.gov (United States)

    Vishnivetsky, Sergey; Shoval, Gal; Leibovich, Vadim; Giner, Lucas; Mitrany, Marsel; Cohen, Dorit; Barzilay, Aliza; Volovick, Louisa; Weizman, Abraham; Zalsman, Gil

    2013-01-01

    The use of physical restraints or a seclusion room for the treatment of adolescents in a psychiatric inpatient setting raises ethical dilemmas. We investigated the attitudes of adolescents towards these two means of confinement. We used a structured questionnaire to collect data on the attitudes of 50 adolescent patients, hospitalized in a closed psychiatric ward, towards the use of physical restraint versus a seclusion room. Seventy per cent of the participants in the study preferred seclusion in the seclusion room over bed restraint, whereas 22% preferred physical restraint. Eighty-two percent described seclusion in the seclusion room as less frightening than restraint. Seventy-four per cent reported that seclusion in the seclusion room improved their mental state to a larger extent than restraint. The inpatient adolescents reported feeling the time they needed to reach a state of calm was shorter when they were confined to the seclusion room than when they were physically restrained (p>.001). The use of a seclusion room may be preferable compared to physical restraint for inpatient adolescents.

  13. Physical Restraint and Antipsychotic Medication Use Among Nursing Home Residents With Dementia.

    Science.gov (United States)

    Foebel, Andrea D; Onder, Graziano; Finne-Soveri, Harriet; Lukas, Albert; Denkinger, Michael D; Carfi, Angelo; Vetrano, Davide L; Brandi, Vincenzo; Bernabei, Roberto; Liperoti, Rosa

    2016-02-01

    To explore antipsychotic (AP) medications and physical restraint use and their effects on physical function and cognition in older nursing home residents. This retrospective cohort studied involved 532 residents with dementia from 57 nursing homes participating in the Services and Health for Elderly in Long-Term Care study. Poisson log regression models explored the effect of physical restraint and/or AP medication use on cognitive or functional decline at 6 months. Physical restraint use was associated with a higher risk of both functional and cognitive decline compared with AP medication use alone. These risks were highest among residents receiving both AP medications and physical restraints, suggesting additive effects. Physical restraint use, and even more strongly, concurrent physical restraint and AP medication use, is related to function and cognitive decline in nursing home residents with dementia. Antipsychotic use is cautioned, but these results suggest physical restraint use is potentially more risky. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  14. [Therapeutic restraint management in Intensive Care Units: Phenomenological approach to nursing reality].

    Science.gov (United States)

    Acevedo-Nuevo, M; González-Gil, M T; Solís-Muñoz, M; Láiz-Díez, N; Toraño-Olivera, M J; Carrasco-Rodríguez-Rey, L F; García-González, S; Velasco-Sanz, T R; Martínez-Álvarez, A; Martin-Rivera, B E

    2016-01-01

    To identify nursing experience on physical restraint management in Critical Care Units. To analyse similarities and differences in nursing experience on physical restraint management according to the clinical context that they are involved in. A multicentre phenomenological study was carried out including 14 Critical Care Units in Madrid, classified according to physical restraint use: Common/systematic use, lacking/personalised use, and mixed use. Five focus groups (23 participants were selected following purposeful sampling) were convened, concluding in data saturation. Data analysis was focused on thematic content analysis following Colaizzi's method. Six main themes: Physical restraint meaning in Critical Care Units, safety (self-retreat vital devices), contribution factors, feelings, alternatives, and pending issues. Although some themes are common to the 3 Critical Care Unit types, discourse differences are found as regards to indication, feelings, systematic use of pain and sedation measurement tools. In order to achieve real physical restraint reduction in Critical Care Units, it is necessary to have a deep understanding of restraints use in the specific clinical context. As self-retreat vital devices emerge as central concept, some interventions proposed in other settings could not be effective, requiring alternatives for critical care patients. Discourse variations laid out in the different Critical Care Unit types could highlight key items that determine the use and different attitudes towards physical restraint. Copyright © 2015 Elsevier España, S.L.U. y SEEIUC. All rights reserved.

  15. Implementation of the Six Core Strategies for Restraint Minimization in a Specialized Mental Health Organization.

    Science.gov (United States)

    Riahi, Sanaz; Dawe, Ian C; Stuckey, Melanie I; Klassen, Philip E

    2016-10-01

    Implementation of the Six Core Strategies to Reduce the Use of Seclusion and Restraint (Six Core Strategies) at a recovery-oriented, tertiary level mental health care facility and the resultant changes in mechanical restraint and seclusion incidents are described. Strategies included increased executive participation; enhanced staff knowledge, skills, and attitudes; development of restraint orders and decision support in the electronic medical record to enable informed debriefing and tracking of events; and implementation of initiatives to include service users and their families in the plan of care. Strategies were implemented in a staged manner across 3 years. The total number of mechanical restraint and seclusion incidents decreased by 19.7% from 2011/12 to 2013/14. Concurrently, the average length of a mechanical restraint or seclusion incident decreased 38.9% over the 36-month evaluation period. Implementation of the Six Core Strategies for restraint minimization effectively decreased the number and length of mechanical restraint and seclusion incidents in a specialized mental health care facility. [Journal of Psychosocial Nursing and Mental Health Services, 54(10), 32-39.]. Copyright 2016, SLACK Incorporated.

  16. Assessment of Malawi’s success in child mortality reduction through the lens of the Catalytic Initiative Integrated Health Systems Strengthening programme: Retrospective evaluation

    Directory of Open Access Journals (Sweden)

    Tanya Doherty

    2015-12-01

    Full Text Available Malawi is estimated to have achieved its Millennium Development Goal (MDG 4 target. This paper explores factors influencing progress in child survival in Malawi including coverage of interventions and the role of key national policies. We performed a retrospective evaluation of the Catalytic Initiative (CI programme of support (2007–2013. We developed estimates of child mortality using four population household surveys undertaken between 2000 and 2010. We recalculated coverage indicators for high impact child health interventions and documented child health programmes and policies. The Lives Saved Tool (LiST was used to estimate child lives saved in 2013. The mortality rate in children under 5 years decreased rapidly in the 10 CI districts from 219 deaths per 1000 live births (95% confidence interval (CI 189 to 249 in the period 1991–1995 to 119 deaths (95% CI 105 to 132 in the period 2006–2010. Coverage for all indicators except vitamin A supplementation increased in the 10 CI districts across the time period 2000 to 2013. The LiST analysis estimates that there were 10 800 child deaths averted in the 10 CI districts in 2013, primarily attributable to the introduction of the pneumococcal vaccine (24% and increased household coverage of insecticide–treated bednets (19%. These improvements have taken place within a context of investment in child health policies and scale up of integrated community case management of childhood illnesses. Malawi provides a strong example for countries in sub–Saharan Africa of how high impact child health interventions implemented within a decentralised health system with an established community–based delivery platform, can lead to significant reductions in child mortality.

  17. Nurses' decision-making in cases of physical restraint: a synthesis of qualitative evidence.

    Science.gov (United States)

    Goethals, Sabine; Dierckx de Casterlé, Bernadette; Gastmans, Chris

    2012-06-01

      This article is a report of a review that aimed to synthesize the available qualitative evidence on nurses' decision-making in cases of physical restraint.   The use of physical restraint in acute and residential healthcare facilities is a widespread practice in many countries. Decisions about the use of physical restraints are complex and ethically laden. The lack of evidence supporting the use of physical restraints, the negative consequences of restraint for patients, and the low availability of alternatives obviously complicate the decision-making.   Research papers published between January 1990 and January 2010 were identified in Cinahl, Embase, Medline, PsycInfo and Web of Science.   A systematic review was carried out to obtain a meta-synthesis of qualitative evidence. The process of meta-synthesis was supported by the Joanna Briggs Institute's guidelines.   The decision-making of nurses dealing with the use of physical restraints is a complex trajectory primarily focused on safety. However, thoughtful decision-making requires nurses to carefully balance different options and associated ethical values. The decision-making process of nurses is influenced by both nurse- and context-related factors.   This review provides a deeper understanding of nurses' decision-making process on the use of physical restraints. Context- and nurse-related factors can hinder nurses from making an ethical decision on the appropriate use of physical restraints. There is an urgent need to stimulate and educate nurses to arrive at an appropriate decision about the use of physical restraints. © 2011 Blackwell Publishing Ltd.

  18. Restraint use in home care: a qualitative study from a nursing perspective

    Science.gov (United States)

    2014-01-01

    Background Despite the growing demand for home care and preliminary evidence suggesting that the use of restraint is common practice in home care, research about restraint use in this setting is scarce. Methods To gain insight into the use of restraints in home care from the perspective of nurses, we conducted a qualitative explorative study. We conducted semi-structured face-to-face interviews of 14 nurses from Wit-Gele Kruis, a home-care organization in Flanders, Belgium. Interview transcripts were analyzed using the Qualitative Analysis Guide of Leuven. Results Our findings revealed a lack of clarity among nurses about the concept of restraint in home care. Nurses reported that cognitively impaired older persons, who sometimes lived alone, were restrained or locked up without continuous follow-up. The interviews indicated that the patient’s family played a dominant role in the decision to use restraints. Reasons for using restraints included “providing relief to the family” and “keeping the patient at home as long as possible to avoid admission to a nursing home.” The nurses stated that general practitioners had no clear role in deciding whether to use restraints. Conclusions These findings suggest that the issue of restraint use in home care is even more complex than in long-term residential care settings and acute hospital settings. They raise questions about the ethical and legal responsibilities of home-care providers, nurses, and general practitioners. There is an urgent need for further research to carefully document the use of restraints in home care and to better understand it so that appropriate guidance can be provided to healthcare workers. PMID:24498859

  19. Who cares for former child soldiers? Mental health systems of care in sierra leone.

    Science.gov (United States)

    J Song, Suzan; van den Brink, Helene; de Jong, Joop

    2013-10-01

    While numerous studies on former child soldiers (FCS) have shown mental health needs, adequate services are a challenge. This study aimed to identify priorities, barriers and facilitators of mental health care for Sierra Leonean FCS. Thematic analysis was done on 24 qualitative interviews with participants from diverse sectors. Priorities of mental distress, substance abuse, and gender-based violence were common among FCS clients. Barriers were governmental support and communication with other providers. Perceived facilitators of care were primary- and secondary-level interventions. A public mental health model would feasibly build upon local, culturally embraced interventions, targeting local priorities and reducing barriers to care.

  20. The Parametrisation of Legal Terminology Concerning Child Maintenance Support in the Swedish and Polish Legal Systems

    Directory of Open Access Journals (Sweden)

    Hadryan Milena

    2017-03-01

    Full Text Available This paper deals with translating legal terminology concerning child maintenance from Polish to Swedish. The analysis covers selected terms regulated in the Polish civil law and their possible Swedish equivalents. The method used is based on the parameterisation of legal terms, which allows the specification of terms by selected parameters, which are understood as mutually exclusive properties. The parameterised equivalents are analysed in the context of various types of recipients. This provides the basis for the choice of appropriate translation strategies. The author also discusses pragmatic equivalents featured in Rikstermbanken, the Swedish national terminological database, and those used in practice.

  1. Uptake of prevention of mother to child transmission interventions in Kenya: health systems are more influential than stigma

    Directory of Open Access Journals (Sweden)

    Kinuthia John

    2011-12-01

    Full Text Available Abstract Background We set out to determine the relative roles of stigma versus health systems in non-uptake of prevention of mother to child transmission (PMTCT of HIV-1 interventions: we conducted cross-sectional assessment of all consenting mothers accompanying infants for six-week immunizations. Methods Between September 2008 and March 2009, mothers at six maternal and child health clinics in Kenya's Nairobi and Nyanza provinces were interviewed regarding PMTCT intervention uptake during recent pregnancy. Stigma was ascertained using a previously published standardized questionnaire and infant HIV-1 status determined by HIV-1 polymerase chain reaction. Results Among 2663 mothers, 2453 (92.1% reported antenatal HIV-1 testing. Untested mothers were more likely to have less than secondary education (85.2% vs. 74.9%, p = 0.001, be from Nyanza (47.1% vs. 32.2%, p Conclusions Antenatal HIV-1 testing and antiretroviral uptake was high (both more than 90% and infant HIV-1 infection risk was low, reflecting high PMTCT coverage. Investment in health systems to deliver HIV-1 testing and antiretrovirals can effectively prevent infant HIV-1 infection despite substantial HIV-1 stigma.

  2. CHILD LABOR IN PALEMBANG

    National Research Council Canada - National Science Library

    Ariyanti, Indri; Marwa, Taufiq; Tarmizi, Nurlina; Soebyakto, Bambang Bemby

    2016-01-01

    This research explains the effects of gender, parents’ education, parent’s income, the number of siblings, childbirth order, the presence of parents and patriarchal kinship system on the probability of child labor in Palembang...

  3. CLASSIFICATION OF RESTRAINTS IN THE OPTIMIZATION PROBLEM OF A COLD-FORMED PROFILE

    Directory of Open Access Journals (Sweden)

    Agnieszka Łukowicz

    2015-11-01

    Full Text Available This work describes the restraints in the optimization problem. This is an important and complicated issue because it requires taking into account a vast range of information related to the design and production. In order to describe the relations of a specific optimization problem, it is essential to adopt appropriate criteria and to collect information on all kinds of restraints, i.e. boundary conditions. The following paper verifies the various restraints and defines three subsets: design assumptions, technological limitations and standard conditions. The provided classification was made with reference to the analysis of the construction applicability of the newly patented cold-formed profile.

  4. Dietary restraint moderates the effects of food exposure on women's body and weight satisfaction.

    Science.gov (United States)

    Geschwind, Nicole; Roefs, Anne; Lattimore, Paul; Fett, Anne-Kathrin; Jansen, Anita

    2008-11-01

    The influence of dietary restraint and food exposure on body satisfaction was tested. Body and weight satisfaction were measured before and after exposure to either high- or low-caloric food, without actual eating. Independent of caloric condition, higher dietary restraint was associated with a decrease in body satisfaction after food exposure. With regard to weight satisfaction, however, the association between higher dietary restraint and decreased weight satisfaction was specific for the high-caloric condition. Thus, the actual eating of food is not necessary for decreased body and weight satisfaction to occur, suggesting an exposure-induced activation of dysfunctional cognitions in restrained eaters.

  5. [Physical and pharmacological restraints in geriatric and gerontology services and centers].

    Science.gov (United States)

    Ramos Cordero, Primitivo; López Trigo, José Antonio; Maíllo Pedraz, Herminio; Paz Rubio, José María

    2015-01-01

    Physical and pharmacological restraints are a controversial issue in the context of geriatric care due to their moral, ethical, social and legal repercussions and, despite this fact, no specific legislation exists at a national level. The use of restraints is being questioned with growing frequency, as there are studies that demonstrate that restraints do not reduce the number of falls or their consequences, but rather can increase them, cause complications, injuries and potentially fatal accidents. Restraints are not always used rationally, despite compromising a fundamental human right, that is, freedom, protected in the Constitution, as well as values and principles, such as dignity and personal self-esteem. There are centers where restraints are applied to more than 50% of patients, and in some cases without the consent of their legal representatives. On some occasions, restraints are used for attaining organizational or environmental objectives, such as complying with tight schedules, and for reducing or avoiding the supervision of patients who walk erratically and, at times, are used indefinitely. Even greater confusion exists with respect to the emerging concept of chemical or pharmacological restraints, since no conceptual framework exists based on scientific evidence, and with sufficient consensus for guiding healthcare workers. In this context, the Sociedad Española de Geriatría y Gerontología (SEGG--Spanish Geriatrics and Gerontology Society), aware of the significance and transcendence of the issue, and in an attempt to preserve and guarantee maximum freedom, dignity and self-esteem, on the one hand, and to ensure the maximum integrity and legal certainty of the persons cared for in geriatric and gerontology services and centers, on the other, decided to create an "Interdisciplinary Committee on Restraints" made up by members from different disciplines and members of SEGG Working Groups or Committees, external health care workers, groups

  6. Dietary Restraint Partially Mediates the Relationship between Impulsivity and Binge Eating Only in Lean Individuals: The Importance of Accounting for Body Mass in Studies of Restraint

    Science.gov (United States)

    Coffino, Jaime A.; Orloff, Natalia C.; Hormes, Julia M.

    2016-01-01

    Binge eating is characteristic of eating and weight-related disorders such as binge eating disorder, bulimia nervosa, and obesity. In light of data suggest impulsivity is associated with overeating specifically in restrained eaters, this study sought to elucidate the exact nature of the associations between these variables, hypothesizing that the relationship between impulsivity and binge eating is mediated by restrained eating. We further hypothesized that the role of dietary restraint as a mediator would be moderated by body mass index (BMI). Study participants (n = 506, 50.6% female) were categorized based on self-reported BMI as under- and normal-weight (BMI Emotion Regulation Scale, and the Binge Eating Scale. Findings provide initial evidence for the hypothesized moderated mediation model, with dietary restraint partially mediating the relationship between impulsivity and binge eating severity only in lean respondents. In respondents with overweight or obesity, impulsivity was significantly correlated with binge eating severity, but not with dietary restraint. Findings inform our conceptualization of dietary restraint as a possible risk factor for binge eating and highlight the importance of accounting for body mass in research on the impact of dietary restraint on eating behaviors. PMID:27757092

  7. Dietary restraint partially mediates the relationship between impulsivity and binge eating only in lean individuals: The importance of accounting for body mass in studies of restraint

    Directory of Open Access Journals (Sweden)

    Jaime Ashley Coffino

    2016-10-01

    Full Text Available Binge eating is characteristic of eating and weight-related disorders such as binge eating disorder, bulimia nervosa, and obesity. In light of data that suggests impulsivity is associated with overeating specifically in restrained eaters, this study sought to elucidate the exact nature of the associations between these variables, hypothesizing that the relationship between impulsivity and binge eating is mediated by restrained eating. We further hypothesized that the role of dietary restraint as a mediator would be moderated by body mass index (BMI. Study participants (n = 506, 50.6% female were categorized based on self-reported BMI as under- and normal weight (BMI < 25, 65.8%, n = 333 or overweight and obese (BMI ≥ 25, 34.2%, n = 173 and completed the restrained eating subscale of the Dutch Eating Behavior Questionnaire, the difficulties with impulse control subscale of the Difficulties with Emotion Regulation Scale, and the Binge Eating Scale. Findings provide initial evidence for the hypothesized moderated mediation model, with dietary restraint partially mediating the relationship between impulsivity and binge eating severity only in lean respondents. In respondents with overweight or obesity, impulsivity was significantly correlated with binge eating severity, but dietary restraint was not. Findings inform our conceptualization of dietary restraint as a possible risk factor for binge eating and highlight the importance of accounting for body mass in research on the impact of dietary restraint on eating behaviors.

  8. Synergy of Midwives and Paraji: Finding the Plurality Side in the Maternal and Child Health Care System

    Directory of Open Access Journals (Sweden)

    Aan Kurniawan

    2016-01-01

    Full Text Available Background: The government issued a Delivery social insurance program (Jampersal to reduce the Maternal and Infant Mortality Rate (MMR and IMR. Choice of aid delivery is a midwife or paraji (TBAs in District Cirinten, Lebak, Banten. This paper reviews the diversity in the system of Maternal and Child Health Service. Methods: descriptive study, conducted in 2012 in the village Cirinten. Conducted in-depth interviews to the midwife and paraji as well as observations of the activities of service delivery by both. Results: Coverage deliveries by health workers in Cirinten health centers was 50.4% in 2011. The concept of ‘traditional’, ‘local’ and ‘modern’ is used to describe the differences between plural MCH system in a community. Three factors related to health seeking behavior that is healing factors, psychological, and sociological. Cirinten community has a continuous historical experience in a belief system that affects the choice of TBAs (paraji. Cultural contact with the medical system affect the view of society through the traditional health care system. Conclusion: Paraji as TBAs in the remote area has a role to be a mediator between the traditional and modern MCH systems. Recomendation: Utilizing paraji to advocate the health care/MCH system to public who still believe in traditional health system through establish communications between them.

  9. 5-HT7 receptors and tryptophan hydroxylase in lymphocytes of rats: mitogen activation, physical restraint or treatment with reserpine.

    Science.gov (United States)

    Urbina, Mary; Arroyo, Rubén; Lima, Lucimey

    2014-01-01

    Serotonin (5-HT)7 receptors in lymphocytes play a relevant role as modulators of T cell functions and might be modified by stress protocols. The aims of this work were to evaluate: (i) the presence of 5-HT7 receptors in specific lymphocyte populations, (ii) the probable modifications of them by inflammatory stress with mitogen and (iii) the effects of physical and pharmacological stress. Blood lymphocytes were isolated by density gradients and differential adhesion to plastic. Concanavalin A (Con A) was systemically administered (500 μg/kg) or added to lymphocyte cultures (2.5 μg/ml, final volume 200 μl). Physical restraint was performed in Plexiglass boxes for 5 h per day for 5 days. Reserpine administration was 2.5 mg/kg for 3 days. Immunocytochemical labeling of CD4+, CD8+ and 5-HT7 receptors, and also tryptophan hydroxylase cells was performed. mRNA of 5-HT7 receptors was evaluated by RT-PCR. Controls were included for each protocol. Con A treatment or culture exposure increased the number of lymphocytes expressing 5-HT7 receptors or tryptophan hydroxylase, as compared to absence of the mitogen. Receptors were present in 12-16% of total rat lymphocytes, in ∼10% of CD4+ and in ∼5% of CD8+ cells from control rats. CD4+ decreased, and CD8+ and 5-HT7 cells increased after physical restraint. Reserpine treatment elevated CD8+ and 5-HT7 cells. Con A and physical restraint, but not reserpine treatment, significantly augmented 5-HT7 receptor mRNA in lymphocytes. Rat lymphocytes, expressing tryptophan hydroxylase, could synthesize 5-HT, functioning as a direct autocrine modulator. The modifications of CD4+, CD8+ and 5-HT7 receptors in lymphocytes by three stress protocols could have an impact on immune responses. In addition, the differential distribution of 5-HT7 receptors indicates potential specific physiopathological roles. © 2014 S. Karger AG, Basel.

  10. A novel ventricular restraint device (ASD) repetitively deliver Salvia miltiorrhiza to epicardium have good curative effects in heart failure management.

    Science.gov (United States)

    Naveed, Muhammad; Wenhua, Li; Gang, Wang; Mohammad, Imran Shair; Abbas, Muhammad; Liao, Xiaoqian; Yang, Mengqi; Zhang, Li; Liu, Xiaolin; Qi, Xiaoming; Chen, Yineng; Jiadi, Lv; Ye, Linlan; Zhijie, Wang; Ding, Chen Ding; Feng, Yu; Xiaohui, Zhou

    2017-09-05

    A novel ventricular restraint is the non-transplant surgical option for the management of an end-stage dilated heart failure (HF). To expand the therapeutic techniques we design a novel ventricular restraint device (ASD) which has the ability to deliver a therapeutic drug directly to the heart. We deliver a Traditional Chinese Medicine (TCM) Salvia miltiorrhiza (Danshen Zhusheye) through active hydraulic ventricular support drug delivery system (ASD) and we hypothesize that it will show better results in HF management than the restraint device and drug alone. SD rats were selected and divided into five groups (n=6), Normal, HF, HF+SM (IV), HF+ASD, HF+ASD+SM groups respectively. Post myocardial infarction (MI), electrocardiography (ECG) showed abnormal heart function in all groups and HF+ASD+SM group showed a significant therapeutic improvement with respect to other treatment HF, HF+ASD, and HF+SM (IV) groups on day 30. The mechanical functions of the heart such as heart rate, LVEDP, and LVSP were brought to normal when treated with ASD+SM and show significant (P valueASD+SM group animals compared with other treatment groups. Masson's Trichrome staining was used to study histopathology of cardiac myocytes and quantification of fibrosis was assessed. The large blue fibrotic area was observed in HF, HF+ASD, and HF+SM (IV) groups while HF+ASD+SM showed negligible fibrotic myocyte at the end of study period (30days). This study proves that novel ASD device augments the therapeutic effect of the drug and delivers Salvia miltiorrhiza to the cardiomyocytes significantly as well as provides additional support to the dilated ventricle by the heart failure. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  11. Level and Intensity of Early Intervention Services for Infants and Toddlers with Disabilities: The Impact of Child, Family, System, and Community-Level Factors on Service Provision

    Science.gov (United States)

    Hallam, Rena A.; Rous, Beth; Grove, Jaime; LoBianco, Tony

    2009-01-01

    Data from a statewide billing and information system for early intervention are used to examine the influence of multiple factors on the level and intensity of services provided in a state early intervention system. Results indicate that child and family factors including entry age, gestational age, Medicaid eligibility, access to third party…

  12. Understanding inequities in child vaccination rates among the urban poor: evidence from Nairobi and Ouagadougou health and demographic surveillance systems.

    Science.gov (United States)

    Soura, Abdramane Bassiahi; Mberu, Blessing; Elungata, Patricia; Lankoande, Bruno; Millogo, Roch; Beguy, Donatien; Compaore, Yacouba

    2015-02-01

    Studies on informal settlements in sub-Saharan Africa have questioned the health benefits of urban residence, but this should not suggest that informal settlements (within cities and across cities and/or countries) are homogeneous. They vary in terms of poverty, pollution, overcrowding, criminality, and social exclusion. Moreover, while some informal settlements completely lack public services, others have access to health facilities, sewers, running water, and electricity. There are few comparative studies that have looked at informal settlements across countries accounting for these contextual nuances. In this paper, we comparatively examine the differences in child vaccination rates between Nairobi and Ouagadougou's informal settlements. We further investigate whether the identified differences are related to the differences in demographic and socioeconomic composition between the two settings. We use data from the Ouagadougou and Nairobi Urban Health and Demographic Surveillance Systems (HDSSs), which are the only two urban-based HDSSs in Africa. The results show that children in the slums of Nairobi are less vaccinated than children in the informal settlements in Ouagadougou. The difference in child vaccination rates between Nairobi and Ouagadougou informal settlements are not related to the differences in their demographic and socioeconomic composition but to the inequalities in access to immunization services.

  13. Cross-Cultural Aspect of Behavior Assessment System for Children-2, Parent Rating Scale-Child: Standardization in Korean Children

    Science.gov (United States)

    Song, Jungeun; Leventhal, Bennett L.; Koh, Yun-Joo; Cheon, Keun-Ah; Hong, Hyun Ju; Kim, Young-Key; Cho, Kyungjin; Lim, Eun-Chung; Park, Jee In

    2017-01-01

    Purpose Our study aimed to examine psychometric properties and cross-cultural utility of the Behavior Assessment System for Children-2, Parent Rating Scale-Child (BASC-2 PRS-C) in Korean children. Materials and Methods Two study populations were recruited: a general population sample (n=2115) of 1st to 6th graders from 16 elementary schools and a clinical population (n=219) of 6–12 years old from 5 child psychiatric clinics and an epidemiological sample of autism spectrum disorder. We assessed the validity and reliability of the Korean version of BASC-2 PRS-C (K-BASC-2 PRS-C) and compared subscales with those used for US populations. Results Our results indicate that the K-BASC-2 PRS-C is a valuable instrument with reliability and validity for measuring developmental psychopathology that is comparable to those in Western population. However, there were some differences noted in the mean scores of BASC-2 PRS-C between Korean and US populations. Conclusion K-BASC-2 PRS-C is an effective and useful instrument with psychometric properties that permits measurement of general developmental psychopathology. Observed Korean-US differences in patterns of parental reports of children's behaviors indicate the importance of the validation, standardization and cultural adaptation for tools assessing psychopathology especially when used in populations different from those for which the instrument was originally created. PMID:28120577

  14. Assessing the Key to Effective Coaching in Parent-Child Interaction Therapy: The Therapist-Parent Interaction Coding System.

    Science.gov (United States)

    Barnett, Miya L; Niec, Larissa N; Acevedo-Polakovich, I David

    2014-06-01

    This paper describes the initial evaluation of the Therapist-Parent Interaction Coding System (TPICS), a measure of in vivo therapist coaching for the evidence-based behavioral parent training intervention, parent-child interaction therapy (PCIT). Sixty-one video-recorded treatment sessions were coded with the TPICS to investigate (1) the variety of coaching techniques PCIT therapists use in the early stage of treatment, (2) whether parent skill-level guides a therapist's coaching style and frequency, and (3) whether coaching mediates changes in parents' skill levels from one session to the next. Results found that the TPICS captured a range of coaching techniques, and that parent skill-level prior to coaching did relate to therapists' use of in vivo feedback. Therapists' responsive coaching (e.g., praise to parents) was a partial mediator of change in parenting behavior from one session to the next for specific child-centered parenting skills; whereas directive coaching (e.g., modeling) did not relate to change. The TPICS demonstrates promise as a measure of coaching during PCIT with good reliability scores and initial evidence of construct validity.

  15. Prenatal stress and balance of the child's cardiac autonomic nervous system at age 5-6 years.

    Directory of Open Access Journals (Sweden)

    Aimée E van Dijk

    Full Text Available OBJECTIVE: Autonomic nervous system (ANS misbalance is a potential causal factor in the development of cardiovascular disease. The ANS may be programmed during pregnancy due to various maternal factors. Our aim is to study maternal prenatal psychosocial stress as a potential disruptor of cardiac ANS balance in the child. METHODS: Mothers from a prospective birth cohort (ABCD study filled out a questionnaire at gestational week 16 [IQR 12-20], that included validated instruments for state anxiety, depressive symptoms, pregnancy-related anxiety, parenting daily hassles and job strain. A cumulative stress score was also calculated (based on 80(th percentiles. Indicators of cardiac ANS in the offspring at age 5-6 years are: pre-ejection period (PEP, heart rate (HR, respiratory sinus arrhythmia (RSA and cardiac autonomic balance (CAB, measured with electrocardiography and impedance cardiography in resting supine and sitting positions. RESULTS: 2,624 mother-child pairs, only single births, were available for analysis. The stress scales were not significantly associated with HR, PEP, RSA and CAB (p≥0.17. Accumulation of maternal stress was also not associated with HR, PEP, RSA and CAB (p≥0.07. CONCLUSION: Results did not support the hypothesis that prenatal maternal psychosocial stress deregulates cardiac ANS balance in the offspring, at least in rest, and at the age of five-six years.

  16. Health system productivity change in Zambia: A focus on the child health services.

    Science.gov (United States)

    Achoki, Tom; Kinfu, Yohannes; Masiye, Felix; Frederix, Geert W J; Hovels, Anke; Leufkens, Hubert G

    2017-02-01

    Efficiency and productivity improvement have become central in global health debates. In this study, we explored productivity change, particularly the contribution of technological progress and efficiency gains associated with improvements in child survival in Zambia (population 15 million). Productivity was measured by applying the Malmquist productivity index on district-level panel data. The effect of socioeconomic factors was further analyzed by applying an ordinary least squares regression technique. During 2004-2009, overall productivity in Zambia increased by 5.0 per cent, a change largely attributed to technological progress rather than efficiency gains. Within-country productivity comparisons revealed wide heterogeneity in favor of more urbanized and densely populated districts. Improved cooking methods, improved sanitation, and better educated populations tended to improve productive gains, whereas larger household size had an adverse effect. Addressing such district-level factors and ensuring efficient delivery and optimal application of existing health technologies offer a practical pathway for further improving population health.

  17. Systemic aspects of conjugal resilience in couples with a child facing cancer and marrow transplantation

    Directory of Open Access Journals (Sweden)

    Julie Martin

    2016-09-01

    Full Text Available Introduction: The negative impact of paediatric cancer on parents is well known and is even greater when intensive treatments are used. This study aimed to describe how couples whose child has received a transplant for the treatment of leukaemia view conjugal resilience and to evaluate the role of we-ness as a precursor of conjugal adjustment. Methods: Four parental couples were interviewed. Interviews were analysed in two ways: inductive thematic analysis and rating of verbal content with the We-ness Coding Scale. Results: Participants report that conjugal resilience involves the identification of the couple as a team and cohesion in the couple. Being a team generates certain collaborative interactions that lead to conjugal resilience. A sense of we-ness in parents is associated with fluctuation in the frequency of themes. Discussion: Participants’ vision of conjugal resilience introduced novel themes. The sense of we-ness facilitates cohesion and the process of conjugal resilience.

  18. Effect of restraint stress on depression-like behaviors in rats after transient focal cerebral ischemic injury

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    test was performed in the rats of each group by sucrose preference test and open field test at the end of the experiment.MAIN OUTCOME MEASURES: Changes of depression-like behaviors of rats in each group.RESULTS: Forty-eight rats were involved in the experiment. Two rats with meningeal irritation sign were excluded from simple MCAO group, and one rat in the MCAO+stress group died of some unclear causes during the experiments. The other 45 rats entered the stage of finial analysis. ① Depression-like behavior assessment results: The rats in the MCAO+ stress group had a significantly decreased preference for sucrose solution, crossing and rearing scores, and increased immobility duration after the 14-day restraint stress,compared with those in other three groups (all P<0.05). ②The neurological status grading and motor performance evaluation: There were significant differences in the two indexes of rats in the simple MCAO group before, 1st and 28th days after modeling (P<0.01), while there was no significant difference before and 28th days after modeling (P>0.05). There were no significant changes in sham-operation group at each time point (P>0.05).CONCLUSION: After being exerted restraint stress, the rats with transient focal ischemic injury may show obvious depression-like behaviors. Therefore, restraint stress can be used as a novel animal modeling method for further studying biological mechanism in central nervous system of post-stroke depression animals.

  19. Effects of Differential Reinforcement, Physical Restraint and Verbal Reprimand on Stereotyped Body-Rocking.

    Science.gov (United States)

    Jena, S. P. K.

    1995-01-01

    A boy with severe mental retardation was unresponsive to his environment and spent 80% of his day body-rocking. Stereotyped body-rocking was greatly reduced via differential reinforcement of incompatible responding (DRI), physical restraint, and reprimand. (JDD)

  20. The Use of Physical Restraint in the Treatment of Self-Injury and as Positive Reinforcement.

    Science.gov (United States)

    Favell, Judith E.; And Others

    1978-01-01

    Three experiments investigated the effects of a treatment package on the self-injurious behavior of three profoundly retarded persons (ages 8-27 years) who appeared to enjoy the physical restraints used to prevent their self-injury. (Author)

  1. Use of psychotropic medication among inpatients during focused efforts in prevention of coercion and restraint

    DEFF Research Database (Denmark)

    Højlund, Mikkel; Høgh, Lene; Munk-Jørgensen, Povl

    and reduced life expectancy. The aim of this study is therefore to quantify the use of psychotropic medication when implementing interventions to reduce coercion and restraint. Methods: Cohort study on patients in risk of agitation and coercion in a psychiatric ward operating without physical restraint......Objective: Department of Psychiatry in Aabenraa participates in a national Danish project supporting efforts to reduce coercion and restraint in psychiatry. Antipsychotic and anxiolytic medicine is widely used among agitated patients, but is also known to contribute to cardio-vascular disease...... the project period. Results: Data collection is carried out during autumn of 2016 and preliminary results will be presented at the meeting in Gothenburg. Conclusions: Data from this study will provide new information to the evaluation of initiatives towards reduction of restraint in psychiatry. It will also...

  2. Examination of ethical dilemmas experienced by adult intensive care unit nurses in physical restraint practices.

    Science.gov (United States)

    Yönt, Gülendam Hakverdioğlu; Korhan, Esra Akin; Dizer, Berna; Gümüş, Fatma; Koyuncu, Rukiye

    2014-01-01

    Nurses are more likely to face the dilemma of whether to resort to physical restraints or not and have a hard time making that decision. This is a descriptive study. A total of 55 nurses participated in the research. For data collection, a question form developed by researchers to determine perceptions of ethical dilemmas by nurses in the application of physical restraint was used. A descriptive analysis was made by calculating the mean, standard deviation, and maximum and minimum values. The nurses expressed (36.4%) having difficulty in deciding to use physical restraint. Nurses reported that they experience ethical dilemmas mainly in relation to the ethic principles of nonmaleficence, beneficence, and convenience. We have concluded that majority of nurses working in critical care units apply physical restraint to patients, although they are facing ethical dilemmas concerning harm and benefit principles during the application.

  3. Theory of Point Contact Restraint and Qualitative Analysis of Robot Grasping

    Institute of Scientific and Technical Information of China (English)

    熊有伦

    1994-01-01

    This paper presents a geometrical representation of robot grasping and a definition of "relative form closure" of point contact restraint based on the concepts of positive linear combination,affine combination,convex combination,etc.in the screw space.The dual equivalence theorem,topological equivalence theorem and algebraic equivalence theorem are derived from the defined restraint cone and freedom cone in the dual screw spaces.A J0-function method of computer-aided grasp planning is implemented more efficiently than other proposed methods.The states of restraint and instantaneous motion of a rigid body grasped by a set of point contacts are specified by the unisense degrees of freedom and unisense degrees of restraint.Finally,a quality measure of robot grasping is provided for the synthesis procedure of relatively form-closed grasp.

  4. Effect of physical restraint reduction on older patients' hospital length of stay.

    Science.gov (United States)

    Kwok, Timothy; Bai, Xue; Chui, Maria Y P; Lai, Claudia K Y; Ho, Daniel W H; Ho, Florence K Y; Woo, Jean

    2012-09-01

    Physical restraints are often used to prevent falls and to secure medical devices in older people in hospitals. Restraint reduction has been advocated on the grounds that physical restraints have negative psychological effects and are not effective in preventing falls. The potential effect of restraint reduction on length of hospital stay (LOS) has not been investigated. This study was undertaken to compare the average length of stay of older patients in a convalescent medical ward setting before and after a restraint reduction program. This is a retrospective study. A convalescent hospital in Hong Kong. This study included 2000 patient episodes. The use of physical restraint, LOS, and clinical outcomes of randomly selected patient episodes in the year before and after the implementation of a restraint reduction program were compared. The clinical outcomes included Modified Functional Ambulatory Categories and modified Barthel index. Subgroup analysis was performed on those with confusion as defined by dementia diagnosis, low abbreviated mental test score, or abnormal mental domain of Norton Score. A total of 958 and 988 patient episodes admitted to 10 medical wards in a convalescent hospital in 2007 and 2009 were examined. There were no significant differences in the baseline characteristics of patients in the 2 years. With the implementation of the restraint reduction scheme, the rate of physical restraint use declined significantly from 13.3% in 2007 to 4.1% in 2009 for all patients. The average LOS of patients was significantly lower in the year after the implementation of restraint reduction (19.5 ± 20.7 versus 16.8 ± 13.4 days in 2007 and 2009 respectively, P < .001). On subgroup analysis, the reduction in LOS was significant in the cognitively impaired patients (23.0 ± 26.5 to 17.8 ± 15.0 days in 2007 and 2009 respectively, P < .001), but not in the cognitively normal patients. There were no significant differences between the 2 years in the incidence of

  5. A Systematic Review and Meta-Analysis of a Measure of Staff/Child Interaction Quality (the Classroom Assessment Scoring System) in Early Childhood Education and Care Settings and Child Outcomes.

    Science.gov (United States)

    Perlman, Michal; Falenchuk, Olesya; Fletcher, Brooke; McMullen, Evelyn; Beyene, Joseph; Shah, Prakesh S

    2016-01-01

    The quality of staff/child interactions as measured by the Classroom Assessment Scoring System (CLASS) in Early Childhood Education and Care (ECEC) programs is thought to be important for children's outcomes. The CLASS is made of three domains that assess Emotional Support, Classroom Organization and Instructional Support. It is a relatively new measure that is being used increasingly for research, quality monitoring/accountability and other applied purposes. Our objective was to evaluate the association between the CLASS and child outcomes. Searches of Medline, PsycINFO, ERIC, websites of large datasets and reference sections of all retrieved articles were conducted up to July 3, 2015. Studies that measured association between the CLASS and child outcomes for preschool-aged children who attended ECEC programs were included after screening by two independent reviewers. Searches and data extraction were conducted by two independent reviewers. Thirty-five studies were systematically reviewed of which 19 provided data for meta-analyses. Most studies had moderate to high risk of bias. Of the 14 meta-analyses we conducted, associations between Classroom Organization and Pencil Tapping and between Instructional Support and SSRS Social Skills were significant with pooled correlations of .06 and .09 respectively. All associations were in the expected direction. In the systematic review, significant correlations were reported mainly from one large dataset. Substantial heterogeneity in use of the CLASS, its dimensions, child outcomes and statistical measures was identified. Greater consistency in study methodology is urgently needed. Given the multitude of factors that impact child development it is encouraging that our analyses revealed some, although small, associations between the CLASS and children's outcomes.

  6. Descriptive analysis of physical restraint (protective holding) among community living adults with intellectual disability.

    Science.gov (United States)

    Luiselli, James K; Sperry, James M; Magee, Christine

    2011-06-01

    We analyzed incidence and implementation patterns of physical restraint (PR) among 448 adults with intellectual disability within community-based day habilitation programs and group homes. PR was implemented exclusively as a consequence for self-harming, aggressive, and environmentally disruptive behaviors. Less than 10% of adults received PR and more than 90% of documented restraints occurred as a planned intervention procedure. Several adults accounted for the majority of PR. The clinical implications of these findings are discussed.

  7. Reducing physical restraint use in alcohol withdrawal patients: a literature review.

    Science.gov (United States)

    Rainier, Nicole C

    2014-01-01

    Alcohol withdrawal patients experience symptoms ranging from mild anxiety and disorientation to severe agitation and hallucinations. The most critical of these patients are treated in intensive care units. Physical restraints are often required to maintain patient safety until symptoms resolve. The use of physical restraints is contradictory to nursing values and is unsupported by evidenced-based literature. A literature review was conducted to see what, if any, alternatives have been tested to improve patient care for this complicated patient population.

  8. DEFINING SECLUSION AND RESTRAINT: LEGAL AND POLICY DEFINITIONS VERSUS CONSUMER AND CARER PERSPECTIVES.

    Science.gov (United States)

    Roper, Cath; McSherry, Bernadette; Brophy, Lisa

    2015-12-01

    The practices of seclusion and restraint may be used in a variety of health settings to control behaviour. Laws and policies that seek to regulate these practices define seclusion and restraint in various ways and there are gaps as to which practices are regulated and in what circumstances. This column provides an overview of consumer and carer perspectives as to what is meant by these practices.

  9. The evolution of the doctrine of restraint of trade in Australia: a law reform perspective

    OpenAIRE

    Cheng, John Wei-Ting

    2017-01-01

    This thesis examines the present state of the common law doctrine of restraint of trade from a law reform perspective. The doctrine was developed in England between the 1600s and mid-1800s and its evolution over the centuries has been a slow and ongoing process. The present state of the doctrine and its application in the Australian jurisdiction presents a challenging set of circumstances due to the difficulties faced by contracting parties when they wish to engage in restraint of trade. ...

  10. Buckling of Euler Columns with a Continuous Elastic Restraint via Homotopy Analysis Method

    Directory of Open Access Journals (Sweden)

    Aytekin Eryılmaz

    2013-01-01

    Full Text Available Homotopy Analysis Method (HAM is applied to find the critical buckling load of the Euler columns with continuous elastic restraints. HAM has been successfully applied to many linear and nonlinear, ordinary and partial, differential equations, integral equations, and difference equations. In this study, we presented the application of HAM to the critical buckling loads for Euler columns with five different support cases continuous elastic restraints. The results are compared with the analytic solutions.

  11. Ethics and praxis: alternative strategies to physical restraint and seclusion in a psychiatric setting.

    Science.gov (United States)

    Taxis, J Carole

    2002-03-01

    This descriptive article highlights a 42-month project in which a comprehensive program revision was implemented in a psychiatric hospital that included numerous alternative strategies to the use of patient restraint and seclusion. The results of this project include a 94% reduction in the rate of restraint and seclusion, development of extensive staff and patient education programs, and comprehensive programmatic alterations consistent with a paradigm shift emphasizing collaboration, empowerment, and ethical clinical practice.

  12. [The objectives of the reform of hospitalisation under restraint in psychiatry].

    Science.gov (United States)

    Ledesma, Enrique

    2012-01-01

    The law of July 5th, 2011 reforms legislation dating from June 27th, 1990. It adds elements identified as missing from the original text over the course of the years following its application. The systematic intervention of a liberties and detention judge could counterbalance the measures simplifying hospitalisation under restraint. Stricter monitoring of "unwieldy" patients is also included in measures which enable treatment under restraint to be given through outpatient care.

  13. Physical restraint use in institutional care of old people in Sweden in 2000 and 2007.

    Science.gov (United States)

    Pellfolk, Tony; Sandman, Per-Olof; Gustafson, Yngve; Karlsson, Stig; Lövheim, Hugo

    2012-07-01

    Physical restraint use is common in institutional care for old people and mainly used to prevent falls, despite the fall-preventive effect of physical restraints being questioned in previous research. The aim of the study was to investigate the use of physical restraints in Sweden in 2000 and 2007. Data were collected from two comparable census surveys conducted in all institutional care units for old people in 2000 (n = 3,669) and 2007 (n = 2,914). Information on residents' characteristics and physical restraint use was collected using the Multi-Dimensional Dementia Assessment Scale (MDDAS). In 2000 16.0% (95% confidence interval (CI) 14.8%-17.2%) of the residents were restrained compared to 18.2% (95% CI 16.8%-19.6%) in 2007 (p = 0.017). Adjusting for residents' characteristics showed that residents in 2007 were more likely to be physically restrained, relative to the residents in 2000 (odds ratio (OR) 1.031, 95% CI 1.005-1.058, p = 0.017). In 2007 the residents had been restrained longer, and a higher proportion were restrained for unknown reasons. Physical restraint use is still common. Moreover, the findings of this study suggest a small increase (OR 1.031) in the prevalence of physical restraint use from 2000 to 2007 adjusted for residents' characteristics.

  14. [Effects of a physical restraint removal program on older people with dementia in residential care].

    Science.gov (United States)

    Tortosa, M Ángeles; Granell, Rafael; Fuenmayor, Amadeo; Martínez, Mary

    2016-01-01

    To analyse the results of removing physical restraints from elderly patients with dementia living in nursing homes. This objective is part of a wider process of change in residential care. Quasi-experimental study conducted in two residences from May 2010 to May 2012. Information was collected at 7 time points and longitudinal analyses were performed. After training staff, the physical restraints in El Puig centre were phased out, while in the Conarda centre, restraints were still applied to elderly people. The main variables studied were: falls, psychotropic medication prescriptions, different indicators of mental impairment, and degree of dependence (Norton, NPI, Mini-mental, Tinetti, Barthel). In the El Puig centre all the physical restraints were removed. A slight improvement was seen in the number of falls, and their consequences. The ANOVA showed significant improvements in the centre that removed restraints in prescribing psychotropic medications, cognitive impairment, and behavioural changes. It is shown that removing physical restraints do not cause negative effects as regards the number of falls, and also positively affects the welfare and independence of elderly people (through changes in behaviour and mental impairment). Furthermore, it is demonstrated that this program must be accompanied by the reduction and control of medicines (withdrawal of the number of psychotropic prescriptions). Copyright © 2014 SEGG. Published by Elsevier Espana. All rights reserved.

  15. Risk for physical restraint or seclusion in the psychiatric emergency service (PES).

    Science.gov (United States)

    Simpson, Scott A; Joesch, Jutta M; West, Imara I; Pasic, Jagoda

    2014-01-01

    We describe risk factors associated with patients experiencing physical restraint or seclusion in the psychiatric emergency service (PES). We retrospectively reviewed medical records, nursing logs and quality assurance data for all adult patient encounters in a PES over a 12-month period (June 1, 2011-May 31, 2012). Descriptors included demographic characteristics, diagnoses, laboratory values, and clinician ratings of symptom severity. χ(2) and multivariate logistic regression analyses were performed. Restraint/seclusion occurred in 14% of 5335 patient encounters. The following characteristics were associated with restraint/seclusion: arrival to the PES in restraints; referral not initiated by the patient; arrival between 1900 and 0059 hours; bipolar mania or mixed episode; and clinician rating of severe disruptiveness, psychosis or insight impairment. Severe suicidality and a depression diagnosis were associated with less risk of restraint or seclusion. Acute symptomatology and characteristics of the encounter were more likely to be associated with restraint/seclusion than patient demographics or diagnoses. These findings support recent guidelines for the treatment of agitation and can help clinicians identify patients at risk of behavioral decompensation. © 2014.

  16. Rappertk: a versatile engine for discrete restraint-based conformational sampling of macromolecules

    Directory of Open Access Journals (Sweden)

    Karmali Anjum M

    2007-03-01

    Full Text Available Abstract Background Macromolecular structures are modeled by conformational optimization within experimental and knowledge-based restraints. Discrete restraint-based sampling generates high-quality structures within these restraints and facilitates further refinement in a continuous all-atom energy landscape. This approach has been used successfully for protein loop modeling, comparative modeling and electron density fitting in X-ray crystallography. Results Here we present a software toolkit (Rappertk which generalizes discrete restraint-based sampling for use in structural biology. Modular design and multi-layered architecture enables Rappertk to sample conformations of any macromolecule at many levels of detail and within a variety of experimental restraints. Performance against a Cα-tracing benchmark shows that the efficiency has not suffered despite the overhead required by this flexibility. We demonstrate the toolkit's capabilities by building high-quality β-sheets and by introducing restraint-driven sampling. RNA sampling is demonstrated by rebuilding a protein-RNA interface. Ability to construct arbitrary ligands is used in sampling protein-ligand interfaces within electron density. Finally, secondary structure and shape information derived from EM are combined to generate multiple conformations of a protein consistent with the observed density. Conclusion Through its modular design and ease of use, Rappertk enables exploration of a wide variety of interesting avenues in structural biology. This toolkit, with illustrative examples, is freely available to academic users from http://www-cryst.bioc.cam.ac.uk/~swanand/mysite/rtk/index.html.

  17. Thinness expectancies and restraint in Black and White college women: a prospective study.

    Science.gov (United States)

    Stojek, Monika M K; Fischer, Sarah

    2013-08-01

    Despite stereotypes to the contrary, women of diverse racial backgrounds, including Black women, experience disordered eating symptoms. While there has been an increase in research comparing disordered eating symptoms across ethnic groups, there remains a dearth of research on the mechanisms of action underlying the development of these symptoms in non-White populations. Thinness expectancies prospectively predict disordered eating symptoms in adolescent girls, but the majority of research on expectancies has been conducted with White samples. Restraint, or self-initiated attempts to restrict food intake, may be precipitated by cognitive factors such as thinness expectancies. In the current study, we followed a sample of Black and White women over one semester of college to assess the influence of thinness expectancies and ethnic identity on restraint. Our sample consisted of 193 college women (93 Black women). We found that White women experienced restraint at higher levels than Black women, but both Black and White women experienced an increase in restraint across the first semester in college. The endorsement of thinness expectancies added significant incremental variance to the prediction of restraint over time, when baseline restraint was included in the model. These effects were not moderated by ethnicity nor ethnic identity. This study adds to the scarce literature on phenomenology of disordered eating in Black women.

  18. Mixed selection. Effects of body images, dietary restraint, and persuasive messages on females' orientations towards chocolate.

    Science.gov (United States)

    Durkin, Kevin; Hendry, Alana; Stritzke, Werner G K

    2013-01-01

    Many women experience ambivalent reactions to chocolate: craving it but also wary of its impact on weight and health. Chocolate advertisements often use thin ideal models and previous research indicates that this exacerbates ambivalence. This experiment compared attitudes to, and consumption of, chocolate following exposure to images containing thin or overweight models together with written messages that were either positive or negative about eating chocolate. Participants (all female) were categorised as either low- or high-restraint. Approach, avoidance and guilt motives towards chocolate were measured and the participants had an opportunity to consume chocolate. Exposure to thin ideal models led to higher approach motives and this effect was most marked among the high restraint participants. Avoidance and guilt scores did not vary as a function of model size or message, but there were clear differences between the restraint groups, with the high restraint participants scoring substantially higher than low restraint participants on both of these measures. When the participants were provided with an opportunity to eat some chocolate, those with high restraint who had been exposed to the thin models consumed the most. Copyright © 2012 Elsevier Ltd. All rights reserved.

  19. Child Development

    Science.gov (United States)

    As children grow older, they develop in several different ways. Child development includes physical, intellectual, social, and emotional changes. Children grow and mature at very different rates. It's ...

  20. 45 CFR 1355.52 - Funding authority for statewide automated child welfare information systems (SACWIS).

    Science.gov (United States)

    2010-10-01

    ... welfare information systems (SACWIS). 1355.52 Section 1355.52 Public Welfare Regulations Relating to... welfare information systems (SACWIS). (a) States may receive Federal reimbursement at the 75 percent match... information system, to the extent such system: (1) Provides for the State to collect and electronically...

  1. Effect of altered 'weight' upon animal tolerance to restraint.

    Science.gov (United States)

    Burton, R. R.; Smith, A. H.; Beljan, J. R.

    1971-01-01

    The effect of altered weight upon animal tolerance to restraint was determined by simulating various accelerative forces with directed lead weights using restrained and nonrestrained domestic fowl (chickens). Weighting (increased weight) and conterweighting (reduced weight) produced a stressed condition - reduced relative lymphocyte counts, loss of body mass, and/or the development of a disorientation syndrome - in both restrained and nonrestrained (caged only) birds. The animal's tolerance to altered weight appeared to be a function of its body weight. Unrestrained birds were stressed by counterweighting (mean plus or minus standard error) 58.3 plus or minus 41% of their body weight, whereas restrained birds tolerated only 32.2 plus or minus 2.6% reduction in body weight. A training regimen for restrained birds was not effective in improving their tolerance to a reduced weight environment. It was concluded that domestic fowl living in a weightless (space) environment should be restrained minimally and supported by ventrally directed tension equivalent to approximately 50% of their body mass (their weight in a 1 G environment).

  2. Developing countries use music videos to promote teen sexual restraint.

    Science.gov (United States)

    Pemberton, M

    1991-12-15

    The Center for Communications Programs of the Johns Hopkins University has successfully produced and aired songs and music videos promoting teenage sexual restraint in developing countries. Entertaining music videos convey accurate messages to target audiences more effectively than teachers and doctors are able. In addition to successes in the Philippines and Nigeria, overwhelming success has been met with Wait, a video with Latin American pop start Tatiana and Johnny. A hit in 11 Latin American countries reaching 1 in Mexico, the video received 1 million hour s free air time. Passionate, powerful, and persuasive, these videos have prompted increased contraceptive use in countries where they have been aired. The Center's videos and songs have proved popular and profitable in a competitive market of ideas, earning 3-4 times their production costs. Accordingly, health experts from Johns Hopkins University recognize the potential role of these productions in preventing AIDS and unwanted pregnancies in other settings. Where Baltimore leads the U.S. in teen pregnancies, the Center would like to air soap opera on sexual responsibility. Production costs in the U.S. are, however, 10 times higher than in developing countries. With the collaboration of media executives, significant financial and social rewards could result from such a production.

  3. Improving a mother to child HIV transmission programme through health system redesign: quality improvement, protocol adjustment and resource addition.

    Directory of Open Access Journals (Sweden)

    Michele S Youngleson

    Full Text Available BACKGROUND: Health systems that deliver prevention of mother to child transmission (PMTCT services in low and middle income countries continue to underperform, resulting in thousands of unnecessary HIV infections of newborns each year. We used a combination of approaches to health systems strengthening to reduce transmission of HIV from mother to infant in a multi-facility public health system in South Africa. METHODOLOGY/PRINCIPAL FINDINGS: All primary care sites and specialized birthing centers in a resource constrained sub-district of Cape Metro District, South Africa, were enrolled in a quality improvement (QI programme. All pregnant women receiving antenatal, intrapartum and postnatal infant care in the sub-district between January 2006 and March 2009 were included in the intervention that had a prototype-innovation phase and a rapid spread phase. System changes were introduced to help frontline healthcare workers to identify and improve performance gaps at each step of the PMTCT pathway. Improvement was facilitated and spread through the use of a Breakthrough Series Collaborative that accelerated learning and the spread of successful changes. Protocol changes and additional resources were introduced by provincial and municipal government. The proportion of HIV-exposed infants testing positive declined from 7.6% to 5%. Key intermediate PMTCT processes improved (antenatal AZT increased from 74% to 86%, PMTCT clients on HAART at the time of labour increased from 10% to 25%, intrapartum AZT increased from 43% to 84%, and postnatal HIV testing from 79% to 95% compared to baseline. CONCLUSIONS/SIGNIFICANCE: System improvement methods, protocol changes and addition/reallocation of resources contributed to improved PMTCT processes and outcomes in a resource constrained setting. The intervention requires a clear design, leadership buy-in, building local capacity to use systems improvement methods, and a reliable data system. A systems improvement

  4. Activation of presynaptic oxytocin receptors enhances glutamate release in the ventral hippocampus of prenatally restraint stressed rats.

    Science.gov (United States)

    Mairesse, Jérôme; Gatta, Eleonora; Reynaert, Marie-Line; Marrocco, Jordan; Morley-Fletcher, Sara; Soichot, Marion; Deruyter, Lucie; Camp, Gilles Van; Bouwalerh, Hammou; Fagioli, Francesca; Pittaluga, Anna; Allorge, Delphine; Nicoletti, Ferdinando; Maccari, Stefania

    2015-12-01

    Oxytocin receptors are known to modulate synaptic transmission and network activity in the hippocampus, but their precise function has been only partially elucidated. Here, we have found that activation of presynaptic oxytocin receptor with the potent agonist, carbetocin, enhanced depolarization-evoked glutamate release in the ventral hippocampus with no effect on GABA release. This evidence paved the way for examining the effect of carbetocin treatment in "prenatally restraint stressed" (PRS) rats, i.e., the offspring of dams exposed to repeated episodes of restraint stress during pregnancy. Adult PRS rats exhibit an anxious/depressive-like phenotype associated with an abnormal glucocorticoid feedback regulation of the hypothalamus-pituitary-adrenal (HPA) axis, and, remarkably, with a reduced depolarization-evoked glutamate release in the ventral hippocampus. Chronic systemic treatment with carbetocin (1mg/kg, i.p., once a day for 2-3 weeks) in PRS rats corrected the defect in glutamate release, anxiety- and depressive-like behavior, and abnormalities in social behavior, in the HPA response to stress, and in the expression of stress-related genes in the hippocampus and amygdala. Of note, carbetocin treatment had no effect on these behavioral and neuroendocrine parameters in prenatally unstressed (control) rats, with the exception of a reduced expression of the oxytocin receptor gene in the amygdala. These findings disclose a novel function of oxytocin receptors in the hippocampus, and encourage the use of oxytocin receptor agonists in the treatment of stress-related psychiatric disorders in adult life.

  5. Predictors of Substance Abuse Assessment and Treatment Completion for Parents Involved with Child Welfare: One State's Experience in Matching across Systems.

    Science.gov (United States)

    Traube, Dorian E; He, Amy S; Zhu, Limei; Scalise, Christine; Richardson, Tyrone

    2015-01-01

    To date, few studies have examined the effect of interagency collaboration on substance abuse assessment ity of Southern California and treatment completion for parents who are involved in child welfare. The purpose of this paper is to: (1) describe a statewide, interagency collaborative program aimed at providing targeted substance abuse assessment and treatment to parents engaged in the child welfare system; (2) document the specialized assessment and treatment outcomes for parents engaged through this collaborative program; and (3) determine factors related to successful treatment completion for parents involved in the child welfare system. This is a retrospective study of an open cohort of 13,829 individuals admitted to the New Jersey Child Protection Substance Abuse Initiative (CPSAI) program from October 1, 2009, through September 30, 2010. Data were drawn from two unique administrative data sources. Multivariate Cox regression models were used to explore factors related to successfil treatment completion for parents involved in the child welfare system. Trend analysis for the total sample in the CPSAI program revealed that, of the 10,909 individuals who received a CPSAI assessment, 59% were referred to treatment. Of those referred to treatment, 40% enrolled in a treatment program. Once enrolled in a treatment program, 55% completed or were in the process of completing substance abuse treatment. These findings suggest that when adequate screening and treatment is available through a streamlined process, many of the ethnic and gender disparities present among other populations of individuals seeking treatment are minimized. Utilizing inherent child welfare case factors appears to be an important motivating element that aids parents during the assessment and treatment process.

  6. A review of the scientific literature related to the adverse impact of physical restraint: gaining a clearer understanding of the physiological factors involved in cases of restraint-related death.

    Science.gov (United States)

    Barnett, Richard; Stirling, Chris; Pandyan, Anand D

    2012-07-01

    Deaths occurring during and/or in close proximity to physical restraint have been attributed to positional asphyxia, a conclusion primarily based on opinion and reviews of case studies. This review sought to identify the current scientific evidence available in regard to the aetiology of adverse events or death occurring during or in close proximity to physical restraint. A systematic search of electronic databases (SPORTDiscus, AMED, CINAHL, MEDLINE, PsycINFO) for papers published in English, between 1980 and 2011, using keywords that related to restraint, restraint position and cardiovascular function resulted in 11 experimental papers being found for review. The term positional asphyxia as a mechanism for sudden death is poorly understood. The literature shows that restraint position has the ability to impede life-maintaining physiological functions, but that the imposed impediment is not uniform across all restraint positions/techniques. Further research is required to ascertain the risks posed by struggling during restraint for more prolonged periods of time and in different positions using varied techniques of restraint. This research should seek to and rank known or future risk factors of adverse events occurring during restraint, seeking to understand the interactions and if present the cumulative effect of these risk factors. Finally, future research should focus on populations other than apparently healthy male adults.

  7. The impact of restraint reduction meetings on the use of restrictive physical interventions in English residential services for children and young people.

    Science.gov (United States)

    Deveau, R; Leitch, S

    2015-07-01

    The aim was to examine the impact of post restraint reduction meetings upon the frequency and restrictiveness of restraint use in English children's residential services. Attention has been drawn to the misuse, overuse and safety of some techniques used to physically restrain children in residential services. Successful interventions to reduce restraints have been reported, mostly from the USA. Demonstrate a significant overall reduction in both, frequency and restrictiveness of restraints; the greatest percentage decrease in the most restrictive floor restraints. Whilst five services reduced both frequency and restrictiveness, five services showed some increases in frequency and/or restrictiveness of restraints employed. Restraint reduction is most effectively reduced through employing multiple strategies and that post restraint reduction meetings maybe one useful component. Organisations seeking to promote restraint reduction meetings need to allocate sufficient priority and resources to support these. © 2014 John Wiley & Sons Ltd.

  8. Evaluation of 6 and 10 Year-Old Child Human Body Models in Emergency Events

    Science.gov (United States)

    2017-01-01

    Emergency events can influence a child’s kinematics prior to a car-crash, and thus its interaction with the restraint system. Numerical Human Body Models (HBMs) can help understand the behaviour of children in emergency events. The kinematic responses of two child HBMs–MADYMO 6 and 10 year-old models–were evaluated and compared with child volunteers’ data during emergency events–braking and steering–with a focus on the forehead and sternum displacements. The response of the 6 year-old HBM was similar to the response of the 10 year-old HBM, however both models had a different response compared with the volunteers. The forward and lateral displacements were within the range of volunteer data up to approximately 0.3 s; but then, the HBMs head and sternum moved significantly downwards, while the volunteers experienced smaller displacement and tended to come back to their initial posture. Therefore, these HBMs, originally intended for crash simulations, are not too stiff and could be able to reproduce properly emergency events thanks, for instance, to postural control. PMID:28099505

  9. Sharing Data between Child Welfare and Education to Improve Outcomes for Children and Youth in the Foster Care System. Policy Brief

    Science.gov (United States)

    Center for the Future of Teaching and Learning, 2010

    2010-01-01

    When a child is placed in the state's foster care system because of a parent's abuse or neglect, the state--represented by teams of social workers, lawyers, judges, foster parents, and other caregivers or guardians--steps into many aspects of the parental role. Too often, though, the state's representatives are attempting to fulfill a parental…

  10. Parentally Bereaved Children's Grief: Self-System Beliefs as Mediators of the Relations between Grief and Stressors and Caregiver-Child Relationship Quality

    Science.gov (United States)

    Wolchik, Sharlene A.; Ma, Yue; Tein, Jenn-Yun; Sandler, Irwin N.; Ayers, Tim S.

    2008-01-01

    We investigated whether 3 self-system beliefs--fear of abandonment, coping efficacy, and self-esteem--mediated the relations between stressors and caregiver-child relationship quality and parentally bereaved youths' general grief and intrusive grief thoughts. Cross-sectional (n = 340 youth) and longitudinal (n = 100 youth) models were tested. In…

  11. Sexual Abuse Histories of Young Women in the U.S. Child Welfare System: A Focus on Trauma-Related Beliefs and Resilience

    Science.gov (United States)

    Breno, Angela L.; Galupo, M. Paz

    2007-01-01

    This research provides descriptive data regarding sexual abuse histories of high-functioning women (N = 84; 18-25 years old) previously in the child welfare system. Placement histories of foster youth who were sexually abused were distinct. Girls with a history of sexual abuse were more likely to have been in restrictive housing and changed…

  12. Stressors, Quality of the Child-Caregiver Relationship, and Children's Mental Health Problems After Parental Death: The Mediating Role of Self-System Beliefs

    Science.gov (United States)

    Wolchik, Sharlene A.; Tein, Jenn-Yun; Sandler, Irwin N.; Ayers, Tim S.

    2006-01-01

    Investigated whether three self-system beliefs, fear of abandonment, coping efficacy, and self-esteem, mediated the relations of stressors and caregiver-child relationship quality with concurrent and prospective internalizing and externalizing problems in a sample of children who had experienced parental death in the previous 2.5 years. The…

  13. Inter-Rater Reliability and Concurrent Validity of the Goodenough-Harris and McCarthy Draw-A-Child Scoring Systems.

    Science.gov (United States)

    Naglieri, Jack A.; Maxwell, Susanna

    1981-01-01

    Inter-rater reliability of the Goodenough-Harris and McCarthy Draw-A-Child scoring systems was examined for a sample of 60 children, including 20 school-labeled learning disabled, 20 mentally retarded, and 20 normal children between the ages of six and eight-and-one-half years. (Author)

  14. Evaluation of the Battelle Developmental Inventory, 2nd Edition, Screening Test for Use in States' Child Outcomes Measurement Systems under the Individuals with Disabilities Education Act

    Science.gov (United States)

    Elbaum, Batya; Gattamorta, Karina A.; Penfield, Randall D.

    2010-01-01

    This study evaluated the Battelle Developmental Inventory, 2nd Edition, Screening Test (BDI-2 ST) for use in states' child outcomes accountability systems under the Individuals with Disabilities Education Act. Complete Battelle Developmental Inventory, 2nd Edition (BDI-2), assessment data were obtained for 142 children, ages 2 to 62 months, who…

  15. A Psychometric Analysis and Standardization of the Behavior Assessment System for Children-2, Self-Report of Personality, Child Version among a Korean Sample

    Science.gov (United States)

    Ahn, Christine M.; Ebesutani, Chad; Kamphaus, Randy

    2014-01-01

    The psychometric properties of the Korean version of the Behavior Assessment System for Children-2, Self-Report of Personality, Child Form (K-BASC-2 SRP-C) are reported. A total of 1100 Korean children ages 8-11 years participated in the study to establish normative data. The results of this study generally supported the factor structure and…

  16. Validity of the OSU Post-Traumatic Stress Disorder Scale and the Behavior Assessment System for Children Self-Report of Personality with Child Tornado Survivors

    Science.gov (United States)

    Evans, Linda Garner; Oehler-Stinnett, Judy

    2008-01-01

    Tornadoes and other natural disasters can lead to anxiety and posttraumatic stress disorder (PTSD) in children. This study provides further validity for the Oklahoma State University Post-Traumatic Stress Disorder Scale-Child Form (OSU PTSDS-CF) by comparing it to the Behavior Assessment System for Children Self-Report of Personality (BASC-SRP).…

  17. Development of comprehensive unattended child warning and feedback system in vehicle

    Directory of Open Access Journals (Sweden)

    Sulaiman Norizam

    2017-01-01

    Full Text Available The cases of children being trapped and suffocated in unattended vehicle keep increasing even though the awareness campaign on the safety of children in non-moving vehicle were carried out by government. Various methods were introduced by researchers to overcome this issue but yet to be effective. Among them were the usage of capacitive sensor, microwave sensor, pressure sensor and image sensor where most of the techniques or systems were applied on the child’s seat to detect the presence of baby or infant. Thus, this research is carried out to provide a comprehensive and effective detection system to detect the presence of children including infant in unattended vehicle by using the combination of human physiological signals (voice and body odor detectors with the temperature and motion sensors. Here, once the proposed system recognizes any signals that generated from voice, odor, motion and temperature detectors in vehicle’s cabin, the system then will provide effective feedback system by sending short message to the parents first. If no response received in the specified allocation time, the system then will activate the vehicle’s horn system. Finally, the system will lower down the vehicle’s window to release the toxic gas and reduce the cabin temperature. The system is in prototyping stage where every design component was evaluated individually. Besides, the overall system was successfully tested where the detection and feedback system follow the instruction given by the microcontroller.

  18. Use of physical restraint in hospital patients: A descriptive study in a tertiary hospital in South Africa.

    Science.gov (United States)

    Kalula, Sebastiana Z; Petros, Sabela G

    2016-11-10

    The use of physical restraint in patient management is a common and emotive issue, and has legal and ethical dimensions. To document the prevalence of physical restraint use, patient characteristics associated with physical restraint use, and nurses' and doctors' knowledge and perceptions towards the practice. A cross-sectional study of 572 patients, of whom 132 were physically restrained, was conducted in acute wards of a tertiary hospital. Data were collected on the 132 physically restrained patients. Fifty-nine doctors and 159 nurses completed a specially constructed questionnaire. Descriptive statistics were derived and expressed as numbers and percentages. Prevalence of restraint use was 23% (132/572). The distribution in acute wards was: medical 54.5%; surgical 44.7%; maternity 0.8%; psychiatry none. Mean age (SD) of the restrained patients was 49 years (20.5); 53.8% were male. The commonest types of restraints used were bed rails 93% and wrist belts 12%. Restraints were used largely to protect medical devices and as protection from harm. Less than 15% of the nurses reported having received training and 36% of the doctors reported having received some guidance on the use of restraints. Only a minority of nurses and doctors knew of a hospital policy on restraint use. Documentation on the prescription and indication for the use of restraint was poor. Prevalence of restraint use is high and poorly coordinated. A policy on the use of restraint and comprehensive guidelines should be developed to guide health care practitioners in the management of patients where restraint cannot be avoided.

  19. Use of physical restraint in hospital patients: A descriptive study in a tertiary hospital in South Africa

    Directory of Open Access Journals (Sweden)

    Sebastiana Z. Kalula

    2016-02-01

    Full Text Available Background: The use of physical restraint in patient management is a common and emotive issue, and has legal and ethical dimensions.Objective: To document the prevalence of physical restraint use, patient characteristics associated with physical restraint use, and nurses’ and doctors’ knowledge and perceptions towards the practice.Methods: A cross-sectional study of 572 patients, of whom 132 were physically restrained, was conducted in acute wards of a tertiary hospital. Data were collected on the 132 physically restrained patients. Fifty-nine doctors and 159 nurses completed a specially constructed questionnaire. Descriptive statistics were derived and expressed as numbers and percentages.Results: Prevalence of restraint use was 23% (132/572. The distribution in acute wards was: medical 54.5%; surgical 44.7%; maternity 0.8%; psychiatry none. Mean age (SD of the restrained patients was 49 years (20.5; 53.8% were male. The commonest types of restraints used were bed rails 93% and wrist belts 12%. Restraints were used largely to protect medical devices and as protection from harm. Less than 15% of the nurses reported having received training and 36% of the doctors reported having received some guidance on the use of restraints. Only a minority of nurses and doctors knew of a hospital policy on restraint use. Documentation on the prescription and indication for the use of restraint was poor.Conclusion: Prevalence of restraint use is high and poorly coordinated. A policy on the use of restraint and comprehensive guidelines should be developed to guide health care practitioners in the management of patients where restraint cannot be avoided.

  20. Physical restraint: experiences, attitudes and opinions of adult intensive care unit nurses.

    Science.gov (United States)

    Freeman, Samantha; Hallett, Christine; McHugh, Gretl

    2016-03-01

    Patients within the adult intensive care unit have the potential to develop delirium and agitation. This can result in the patient displaying unwanted behaviours such as attempting to remove the medical devices to which they are attached. Some adult intensive care units within the UK are starting to adopt physical restraint as a method of managing unwanted behaviours. To determine the experiences, attitudes and opinions of adult intensive care nurses in relation to the application of physical restraint. Questionnaire survey. A postal questionnaire was distributed to all nurses (n = 192) within two purposefully selected large adult intensive care units in the UK. Data were collected between November 2012 and February 2013. The questionnaire was completed by 38·9% (n = 75) of the nurses contacted. All believed that physical restraint had a place, with the majority of the view that the reason for its application was to maintain patient safety. Some expressed discomfort about the use of physical restraint. Nurses were happy to discuss the use of restraint with families. There was a perceived need for training and support for nursing staff as well as the need for medical staff to support the decision-making process. Nurses require more support and evidence to base their decision-making upon. They require guidance from professional bodies as well as support from medical colleagues. The findings have limited generalizability as they can only be applied to the units accessed and the response rate was poor. Alternative approaches such as pain management, sleep promotion and the involvement of relatives need to be explored before physical restraint policy can be written. Further research is required into the safety of physical restraint, alternative methods of managing the risk of agitation and identifying predisposing factors to accidental device removal. © 2015 British Association of Critical Care Nurses.