WorldWideScience

Sample records for prehensile foot restraint

  1. 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.

  2. Neuroplasticity of prehensile neural networks after quadriplegia.

    Science.gov (United States)

    Di Rienzo, F; Guillot, A; Mateo, S; Daligault, S; Delpuech, C; Rode, G; Collet, C

    2014-08-22

    Targeting cortical neuroplasticity through rehabilitation-based practice is believed to enhance functional recovery after spinal cord injury (SCI). While prehensile performance is severely disturbed after C6-C7 SCI, subjects with tetraplegia can learn a compensatory passive prehension using the tenodesis effect. During tenodesis, an active wrist extension triggers a passive flexion of the fingers allowing grasping. We investigated whether motor imagery training could promote activity-dependent neuroplasticity and improve prehensile tenodesis performance. SCI participants (n=6) and healthy participants (HP, n=6) took part in a repeated measurement design. After an extended baseline period of 3 weeks including repeated magnetoencephalography (MEG) measurements, MI training was embedded within the classical course of physiotherapy for 5 additional weeks (three sessions per week). An immediate MEG post-test and a follow-up at 2 months were performed. Before MI training, compensatory activations and recruitment of deafferented cortical regions characterized the cortical activity during actual and imagined prehension in SCI participants. After MI training, MEG data yielded reduced compensatory activations. Cortical recruitment became similar to that in HP. Behavioral analysis evidenced decreased movement variability suggesting motor learning of tenodesis. Data suggest that MI training participated to reverse compensatory neuroplasticity in SCI participants, and promoted the integration of new upper limb prehensile coordination in the neural networks functionally dedicated to the control of healthy prehension before injury.

  3. Prehensile apparatus

    Science.gov (United States)

    Smith, C.M.

    1993-10-12

    The present invention relates to an apparatus for handling a workpiece comprising a vessel that is longitudinally extensible and pressurizable, and a nonextensible and laterally flexible member on the vessel. The member constrains one side of the vessel to be nonextensible, causing the vessel to bend in the direction of the nonextensible member when pressurized. 8 figures.

  4. 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...

  5. 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

  6. 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…

  7. Functional correlates of fiber architecture of the lateral caudal musculature in prehensile and nonprehensile tails of the platyrrhini (primates) and procyonidae (carnivora).

    Science.gov (United States)

    Organ, Jason M; Teaford, Mark F; Taylor, Andrea B

    2009-06-01

    Prehensile-tailed platyrrhines (atelines and Cebus) and procyonids (Potos) display bony tail features that have been functionally and adaptively linked to their prehensile behaviors, particularly the need to resist relatively greater bending and torsional stresses associated with supporting their body weight during suspensory postures. We compared fiber architecture of the mm. intertransversarii caudae (ITC), the prime tail lateral flexors/rotators, in 40 individuals distributed across 8 platyrrhine and 2 procyonid genera, divided into one of two groups: prehensile or nonprehensile. We tested the hypothesis that prehensile-tailed taxa exhibit relatively greater physiologic cross-sectional areas (PCSAs) to maintain tail suspensory postures for extended periods. As an architectural trade-off of maximizing force, we also predicted prehensile-tailed taxa would exhibit relatively shorter, more pinnate fibers, and a lower mass to tetanic tension ratio (Mass/P(O)). Prehensile-tailed taxa have relatively higher PCSAs in all tail regions, indicating their capacity to generate relatively greater maximum muscle forces compared to nonprehensile-tailed taxa. Contrary to our predictions, there are no group differences in pinnation angles, fiber lengths or M/P(O) ratios. Therefore, the relatively greater prehensile PCSAs are driven largely by relative increase in muscle mass. These findings suggest that relatively greater ITC PCSAs can be functionally linked to the need for prehensile-tailed taxa to suspend and support their body weight during arboreal behaviors. Moreover, maximizing ITC force production may not come at the expense of muscle excursion/contraction velocity. One advantage of this architectural configuration is it facilitates suspension of the body while simultaneously maximizing tail contact with the substrate.

  8. Tail growth tracks the ontogeny of prehensile tail use in capuchin monkeys (Cebus albifrons and C. apella).

    Science.gov (United States)

    Russo, Gabrielle A; Young, Jesse W

    2011-11-01

    Physical anthropologists have devoted considerable attention to the structure and function of the primate prehensile tail. Nevertheless, previous morphological studies have concentrated solely on adults, despite behavioral evidence that among many primate taxa, including capuchin monkeys, infants and juveniles use their prehensile tails during a greater number and greater variety of positional behaviors than do adults. In this study, we track caudal vertebral growth in a mixed longitudinal sample of white-fronted and brown capuchin monkeys (Cebus albifrons and Cebus apella). We hypothesized that young capuchins would have relatively robust caudal vertebrae, affording them greater tail strength for more frequent tail-suspension behaviors. Our results supported this hypothesis. Caudal vertebral bending strength (measured as polar section modulus at midshaft) scaled to body mass with negative allometry, while craniocaudal length scaled to body mass with positive allometry, indicating that infant and juvenile capuchin monkeys are characterized by particularly strong caudal vertebrae for their body size. These findings complement previous results showing that long bone strength similarly scales with negative ontogenetic allometry in capuchin monkeys and add to a growing body of literature documenting the synergy between postcranial growth and the changing locomotor demands of maturing animals. Although expanded morphometric data on tail growth and behavioral data on locomotor development are required, the results of this study suggest that the adult capuchin prehensile-tail phenotype may be attributable, at least in part, to selection on juvenile performance, a possibility that deserves further attention. Copyright © 2011 Wiley-Liss, Inc.

  9. Myosin isoform expression in the prehensile tails of didelphid marsupials: functional differences between arboreal and terrestrial opossums.

    Science.gov (United States)

    Rupert, J E; Schmidt, E Cordero; Moreira-Soto, A; Herrera, B Rodríguez; Vandeberg, J L; Butcher, M T

    2014-08-01

    Prehensile tails are defined as having the ability to grasp objects and are commonly used as a fifth appendage during arboreal locomotion. Despite the independent evolution of tail prehensility in numerous mammalian genera, data relating muscle structure, physiology, and function of prehensile tails are largely incomplete. Didelphid marsupials make an excellent model to relate myosin heavy chain (MHC) isoform fiber type with structure/function of caudal muscles, as all opossums have a prehensile tail and tail use varies between arboreal and terrestrial forms. Expanding on our previous work in the Virginia opossum, this study tests the hypothesis that arboreal and terrestrial opossums differentially express faster versus slower MHC isoforms, respectively. MHC isoform expression and percent fiber type distribution were determined in the flexor caudae longus (FCL) muscle of Caluromys derbianus (arboreal) and Monodelphis domestica (terrestrial), using a combination of gel electrophoresis and immunohistochemistry analyses. C. derbianus expresses three MHC isoforms (1, 2A, 2X) that are distributed (mean percentage) as 8.2% MHC-1, 2.6% 1/2A, and 89.2% 2A/X hybrid fibers. M. domestica also expresses MHC-1, 2A, and 2X, in addition to the 2B isoform, distributed as 17.0% MHC-1, 1.3% 1/2A, 9.0% 2A, 75.2% 2A/X, and 0.3% 2X/B hybrid fibers. The distribution of similar isoform fiber types differed significantly between species (P derbianus was observed to have larger cross-sectional area (CSA) for each corresponding fiber type along with a greater amount of extra-cellular matrix. An overall faster fiber type composition (and larger fibers) in the tail of an arboreal specialist supports our hypothesis, and correlates with higher muscle force required for tail hanging and arboreal maneuvering on terminal substrates. Conversely, a broader distribution of highly oxidative fibers in the caudal musculature is well suited for tail nest building/remodeling behaviors of terrestrial

  10. [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.

  11. 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...

  12. 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…

  13. 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.

  14. 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.

  15. 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)

  16. 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.

  17. 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...

  18. Foot Health

    Science.gov (United States)

    ... straight across and not too short Your foot health can be a clue to your overall health. For example, joint stiffness could mean arthritis. Tingling ... foot checks are an important part of your health care. If you have foot problems, be sure ...

  19. 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...

  20. Cavus Foot Surgery

    Science.gov (United States)

    ... All Site Content AOFAS / FootCareMD / Treatments Cavus Foot Surgery Page Content What is a cavus foot? A ... problems. What are the goals of cavus foot surgery? The main goal of surgery is to reduce ...

  1. Club foot

    DEFF Research Database (Denmark)

    Engell, V; Damborg, F; Andersen, M;

    2006-01-01

    The aetiology of congenital club foot is unclear. Although studies on populations, families and twins suggest a genetic component, the mode of inheritance does not comply with distinctive patterns. The Odense-based Danish Twin Registry contains data on all 73,000 twin pairs born in Denmark over t...

  2. 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.

  3. Mycetoma foot

    Directory of Open Access Journals (Sweden)

    Somnath Gooptu

    2013-01-01

    Full Text Available Mycetoma is an uncommon chronic granulomatous infective disease of the skin, dermis and subcutaneous tissues predominantly seen in tropical countries. A patient presented to our hospital with the swelling of the left foot with a healed sinus and a painful nodule. He gave a history of sinuses in the left foot from which there was discharge of yellow granules. Culture of the ultrasound guided fine needle aspiration cytology of the nodule revealed growths of Nocardia species. The patient was treated with a multi-drug therapy along with debridement of the painful nodule. He experienced symptomatic relief and a regression of the swelling within the three months of follow-up so far. Due to the relatively slow progression of the disease, patients are diagnosed at a late stage. Hence, emphasis should be placed on health education and the importance of wearing footwear.

  4. 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.

  5. Foot amputation - discharge

    Science.gov (United States)

    Amputation - foot - discharge; Trans-metatarsal amputation - discharge ... You have had a foot amputation. You may have had an accident, or your foot may have had an infection or disease and doctors could not save ...

  6. 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.

  7. 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

  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. 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.

  10. 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…

  11. 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

  12. 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.

  13. 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.

  14. Diabetes and Foot Problems

    Science.gov (United States)

    ... Charcot’s foot . Charcot’s foot may start with redness, warmth, and swelling. Later, bones in your feet and ... is safe) or your elbow to test the warmth of the water. Do not soak your feet ...

  15. Adult Foot Health

    Science.gov (United States)

    ... foot will usually respond to treatment with anti-fungal powders and lotions along with good foot hygiene. ... strikes thousands of Americans. This special type of arthritis can be diagnosed only by medical examination and ...

  16. Prevention of foot blisters.

    Science.gov (United States)

    Knapik, Joseph J

    2014-01-01

    Foot blisters are the most common medical problem faced by Soldiers during foot march operations and, if untreated, they can lead to infection. Foot blisters are caused by boots rubbing on the foot (frictional forces), which separates skin layers and allows fluid to seep in. Blisters can be prevented by wearing properly sized boots, conditioning feet through regular road marching, wearing socks that reduce reduce friction and moisture, and possibly applying antiperspirants to the feet.

  17. 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

  18. 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.

  19. 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.

  20. 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...

  1. 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.

  2. 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.

  3. 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.

  4. 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.

  5. 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…

  6. 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.

  7. Paraboloid Shell As Footing

    OpenAIRE

    Al Ansari, Mohammed S.

    1999-01-01

    A simplified method for the design of paraboloid shell footing base on the displacement of the shell's crown where the column axial load is transferred to the footing has been developed. A case study was presented to demonstrate the use of the proposed method and to illustrate its capabilities. The results of the proposed method confirm the ability of the shell model in determining accurate and practical results for the design of paraboloid shell footing. Base on the analytical results of thi...

  8. Electric foot shock stress adaptation: Does it exist or not?

    Science.gov (United States)

    Bali, Anjana; Jaggi, Amteshwar Singh

    2015-06-01

    Stress adaptation is a protective phenomenon against repeated stress exposure and is characterized by a decreased responsiveness to a repeated stress stimulus. The adaptation is associated with a complex cascade of events, including the changes in behavior, neurotransmitter and gene expression levels. The non-adaptation or maladaptation to stress may underlie the affective disorders, such as anxiety, depression and post-traumatic stress disorder (PTSD). Electric foot shock is a complex stressor, which includes both physical and emotional components. Unlike immobilization, restraint and cold immersion stress, the phenomenon of stress adaptation is not very well defined in response to electric foot shock. A number of preclinical studies have reported the development of adaptation to electric foot shock stress. However, evidence also reveals the non-adaptive behavior in response to foot shocks. The distinct adaptive/non-adaptive responses may be possibly influenced by the type, intensity, and duration of the stress. The present review discusses the existence or non-existence of adaptation to electric foot shock stress along with possible mechanism.

  9. 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.

  10. 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.

  11. Effect of foot load changes on foot arch evaluation using foot pressure distribution data

    National Research Council Canada - National Science Library

    Kazuya Imaizumi; Yumi Iwakami; Kazuhiko Yamashita

    2014-01-01

    ... be helpful in health support for the elderly. The present authors have developed a classification system for foot arch type showing high reliability using foot pressure distribution data [1-2]. However, effect of foot load changes on foot arch evaluation remains unclear. The aim of this study was to investigate the effect of foot load chan...

  12. 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.

  13. 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

  14. Diabetic foot infections.

    Science.gov (United States)

    Gemechu, Fassil W; Seemant, Fnu; Curley, Catherine A

    2013-08-01

    Diabetic foot infection, defined as soft tissue or bone infection below the malleoli, is the most common complication of diabetes mellitus leading to hospitalization and the most frequent cause of nontraumatic lower extremity amputation. Diabetic foot infections are diagnosed clinically based on the presence of at least two classic findings of inflammation or purulence. Infections are classified as mild, moderate, or severe. Most diabetic foot infections are polymicrobial. The most common pathogens are aerobic gram-positive cocci, mainly Staphylococcus species. Osteomyelitis is a serious complication of diabetic foot infection that increases the likelihood of surgical intervention. Treatment is based on the extent and severity of the infection and comorbid conditions. Mild infections are treated with oral antibiotics, wound care, and pressure off-loading in the outpatient setting. Selected patients with moderate infections and all patients with severe infections should be hospitalized, given intravenous antibiotics, and evaluated for possible surgical intervention. Peripheral arterial disease is present in up to 40% of patients with diabetic foot infections, making evaluation of the vascular supply critical. All patients with diabetes should undergo a systematic foot examination at least once a year, and more frequently if risk factors for diabetic foot ulcers exist. Preventive measures include patient education on proper foot care, glycemic and blood pressure control, smoking cessation, use of prescription footwear, intensive care from a podiatrist, and evaluation for surgical interventions as indicated.

  15. 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.

  16. 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)

  17. 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

  18. 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)

  19. 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...

  20. 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.

  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. 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...

  3. 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...

  4. 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.

  5. 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...

  6. 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.

  7. 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

    With permanent human presence onboard the International Space Station (ISS), a crew will be living and working in microgravity, interfacing with their physical environment. Without optimum restraints and mobility aids (R&MA' s), the crewmembers may be handicapped for perfonning some of the on-orbit tasks. 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 and may cause prolonged periods of unnatural postures. Thus, determining the right set of human factors requirements and providing an ergonomically designed environment are crucial to astronauts' well-being and productivity. The purpose of this project is to develop requirements and guidelines, and conceptual designs, for an ergonomically designed multi-purpose crew restraint. In order to achieve this goal, the project would involve development of functional and human factors requirements, design concept prototype development, analytical and computer modeling evaluations of concepts, two sets of micro gravity evaluations and preparation of an implementation plan. It is anticipated that developing functional and design requirements for a multi-purpose restraint would facilitate development of ergonomically designed restraints to accommodate the off-nominal but repetitive tasks, and minimize the performance degradation due to lack of optimum setup for onboard task performance. In addition, development of an ergonomically designed restraint concept prototype would allow verification and validation of the requirements defined. To date, we have identified "unique" tasks and areas of need, determine characteristics of "ideal" restraints, and solicit ideas for restraint and mobility aid concepts. Focus group meetings with representatives from training, safety, crew, human factors, engineering, payload developers, and analog environment representatives were key to assist in the development of a restraint

  8. 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

  9. Dynamic Foot Morphology

    OpenAIRE

    Barisch-Fritz, Bettina

    2014-01-01

    Background: The foot has to fulfil important and complex functions which are, in most regions of the world, supported by shoes. The interface of feet and footwear has often been considered with respect to comfort and function but also to negative effects of shoes. One main contribution to the improvement of footwear fit is provided by matching the shape of the shoe to the shape of the foot. However, current approaches for implementation only include static information. There is still a lack o...

  10. [Minor foot amputations in diabetic foot syndrome].

    Science.gov (United States)

    Biehl, C; Eckhard, M; Szalay, G; Heiss, C

    2016-10-01

    The treatment strategy for diabetic foot syndrome must take into account protective sensibility of the foot, open wounds, infection status, and the rules of septic bone surgery. Interventions are classified as elective, prophylactic, curative, or emergency. Amputations in the forefoot and midfoot region are performed as ray amputations (including metatarsal), which can often be carried out as "inner" amputations. Gentle tissue treatment mandatory because of greater risk of revision with re-amputation compared to classical amputation. Good demarcation of infection, acute osteomyelitis, osteolytic lesions, neurotropic ulcer, arterial and venous blood flow to the other toes, gangrene of other toes with metatarsal affection. Arterial occlusive disease, infection of neighboring areas, avoidable amputations, poorly healing ulcers on the lower leg. Primary dorsal approach; minimal incisional distance (5 cm) to minimize skin necrosis risk. Atraumatic preparation, minimize hemostasis to not compromise the borderline perfusion situation. In amputations, plantar skin preparation and longer seams placed as dorsal as possible, either disarticulated and maintain cartilage, or round the cortical metatarsal bone after resection. Diabetes control. Braun splint, mobilization in a shoe with forefoot decompression and hindfoot support, physiotherapy. Antibiotics based on resistance testing. If no complications, dressing change on postoperative day 1. Optimal wound drainage by lowering foot several times a day; drainage removal after 12-24 h. Insoles and footwear optimization. Amputations require continued attention and if necessary treatment to avoid sequelae. Insufficient treatment associated with recurrent ulceration and altered anatomy.

  11. Education for diabetic foot

    Directory of Open Access Journals (Sweden)

    Fabio Batista

    2009-03-01

    Full Text Available Objective: The purpose of this investigation was to stratify the risk in a consecutive group of diabetic patients presenting, for the first time, in a diabetic foot clinic. Additional aims were to investigate the preventive measures in the local health system and to evaluate the level of patient’s awareness about diabetic foot-associated morbidity. Methods: Fifty consecutive adult diabetic patients referred to a Diabetic Foot Clinic of a Municipal Public Hospital comprised the sample for this observational study. The enrollment visit was considered as the first health-system intervention for potential foot morbidity. The average time elapsed since a diagnosis of diabetes among patients was five years. Rresults: At the time of presentation, 94% of sample was not using appropriate footwear. Pedal pulses (dorsalis pedis and/or posterior tibial arteries were palpable in 76% of patients. Thirty subjects (60% had signs of peripheral neuropathy. Twenty-one subjects (42% had clinical deformity. There was a positive correlation between a history of foot ulcer, the presence of peripheral neuropathy, and the presence of foot deformity (p < 0.004 in each correlation. Cconclusions: Informing and educating the patients and those interested in this subject and these problems is essential for favorable outcomes in this scenario.

  12. 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.

  13. 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.

  14. 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…

  15. 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...

  16. 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.

  17. 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...

  18. 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.

  19. 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...

  20. 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.

  1. 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.

  2. 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.

  3. Charcot foot syndrome.

    Science.gov (United States)

    Jeffcoate, W J

    2015-06-01

    Charcot foot syndrome is an uncommon complication of diabetes but is potentially devastating in its consequences. Outcome is made worse by widespread professional ignorance leading to delayed diagnosis, but it is also hampered by lack of understanding of its causes and lack of treatments with proven effectiveness, other than offloading. There remains a desperate need for studies into its causes as well as comparative audit and trials designed to determine the best treatment for this difficult condition. Such work can probably only be effectively carried out through the establishment of multicentre networks. Nevertheless, improved understanding in recent years of the likely role of inflammatory pathways has raised awareness of the multiple ways in which the effects of neuropathy may be manifest in the development of the Charcot foot. This awareness is also leading to the realization that similar processes may conceivably contribute to the refractoriness of other foot diseases in diabetes, including both chronic unhealing ulcers and osteomyelitis.

  4. Foot muscles strengthener

    Directory of Open Access Journals (Sweden)

    Boris T. Glavač

    2012-04-01

    Full Text Available Previous experience in the correction of flat feet consisted of the use of insoles for shoes and exercises with toys, balls, rollers, inclined planes, etc. A device for strengthening foot muscles is designed for the correction of flat feet in children and, as its name suggests, for strengthening foot muscles in adults. The device is made of wood and metal, with a mechanism and technical solutions, enabling the implementation of specific exercises to activate muscles responsible for the formation of the foot arch. It is suitable for home use with controlled load quantities since it has calibrated springs. The device is patented with the Intellectual Property Office, Republic of Serbia, as a petty patent.

  5. [The diabetic foot].

    Science.gov (United States)

    Stirnemann, P; Z'Brun, A; Brunner, D

    1998-10-01

    Problems of the diabetic foot are frequent. The magnitude of the clinical picture and morbidity mirrors the severity and complexity of the underlying pathobiology. The three pathogenetic mechanism involved are ischemia, neuropathy and infection. Seldom do these mechanisms work in isolation, rather most foot problems result from a complex interplay among all three. The clinical picture of the diabetic foot reaches from the neuropathic deformity with diminished or absent sensation of pain to limited gangrene or superficial ulcer. The polymicrobial infection leads to extensive tissue destruction (plantarphlegmone) with osteomyelitis. The patients often notes no pain and may become aware of the infection only through the presence of drainage or a foul odor. These infections are usually more extensive than would be predicted by clinical signs and symptoms. These lesions must be debrided and drained promptly and completely. This often requires amputations of one or more toes, combined with an incision along the entire course of the infected track on the plantar or dorsal aspect of the foot. Cultures should be taken from the depth of the wound. Initial treatment should be with broad-spectrum antibiotics, with subsequent adjustment based on culture results. The diabetic foot is a clinical problem that can be solved with a high degree of success when the approached by an interdisciplinary team (specialists in infectious and vascular disease, podiatry and diabetology). Arterial reconstruction should be designed to restore maximum perfusion to the foot. The most effective result can be obtained with infra-inguinal vein bypass with distal anastomosis to the most proximal artery with direct continuity to the ischemic territory. The single most important factor in the achievement of the reduction of amputation is the autologous vein bypass. The overall outcome in the diabetic patient in terms of graft patency and limb salvage is equal to that in the nondiabetic.

  6. 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.

  7. 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.

  8. Foot Push-Up Test

    Science.gov (United States)

    ... may be inflamed and may have been overworked. Consulting a foot and ankle surgeon for weak and ... or last name. Search Where do you hurt? Interactive Foot Diagram Arch Supports Arch supports are devices ...

  9. What Is a Foot and Ankle Surgeon?

    Science.gov (United States)

    ... Foot & Ankle Surgeon? A A A | Print | Share What is a Foot & Ankle Surgeon? Foot and ankle ... of conditions that affect people of every age. What education has a foot and ankle surgeon received? ...

  10. Osteomyelitis in the diabetic foot

    OpenAIRE

    Malhotra, Rishi; Chan, Claire Shu-Yi; Nather, Aziz

    2014-01-01

    Osteomyelitis (OM) is a common complication of diabetic foot ulcers and/or diabetic foot infections. This review article discusses the clinical presentation, diagnosis, and treatment of OM in the diabetic foot. Clinical features that point to the possibility of OM include the presence of exposed bone in the depth of a diabetic foot ulcer. Medical imaging studies include plain radiographs, magnetic resonance imaging, and bone scintigraphy. A high index of suspicion is also required to make the...

  11. Adult cavovarus foot.

    Science.gov (United States)

    Younger, Alastair S E; Hansen, Sigvard T

    2005-09-01

    Cavovarus foot deformity, which often results from an imbalance of muscle forces, is commonly caused by hereditary motor sensory neuropathies. Other causes are cerebral palsy, cerebral injury (stroke), anterior horn cell disease (spinal root injury), talar neck injury, and residual clubfoot. In cavovarus foot deformity, the relatively strong peroneus longus and tibialis posterior muscles cause a hindfoot varus and forefoot valgus (pronated) position. Hindfoot varus causes overload of the lateral border of the foot, resulting in ankle instability, peroneal tendinitis, and stress fracture. Degenerative arthritic changes can develop in overloaded joints. Gait examination allows appropriate planning of tendon transfers to correct stance and swing-phase deficits. Inspection of the forefoot and hindfoot positions determines the need for soft-tissue release and osteotomy. The Coleman block test is invaluable for assessing the cause of hindfoot varus. Prolonged use of orthoses or supportive footwear can result in muscle imbalance, causing increasing deformity and irreversible damage to tendons and joints. Rebalancing tendons is an early priority to prevent unsalvageable deterioration of the foot. Muscle imbalance can be corrected by tendon transfer, corrective osteotomy, and fusion. Fixed bony deformity can be addressed by fusion and osteotomy.

  12. X-Ray Exam: Foot

    Science.gov (United States)

    ... Old Feeding Your 1- to 2-Year-Old X-Ray Exam: Foot KidsHealth > For Parents > X-Ray Exam: Foot A A A What's in ... español Radiografía: pie What It Is A foot X-ray is a safe and painless test that ...

  13. Neuropathy and Diabetic Foot Syndrome.

    Science.gov (United States)

    Volmer-Thole, Maren; Lobmann, Ralf

    2016-06-10

    Diabetic foot ulceration is a serious complication of diabetes mellitus worldwide and the most common cause of hospitalization in diabetic patients. The etiology of diabetic foot ulcerations is complex due to their multifactorial nature; in the pathophysiology of diabetic foot ulceration polyneuropathy is important. Proper adherence to standard treatment strategies and interdisciplinary cooperation can reduce the still high rates of major amputations.

  14. Foot posture, foot function and low back pain: the Framingham Foot Study

    OpenAIRE

    Menz, Hylton B; Dufour, Alyssa B; Riskowski, Jody L; Hillstrom, Howard J.; Hannan, Marian T.

    2013-01-01

    Objective. Abnormal foot posture and function have been proposed as possible risk factors for low back pain, but this has not been examined in detail. The objective of this study was to explore the associations of foot posture and foot function with low back pain in 1930 members of the Framingham Study (2002–05).

  15. Foot posture, foot function and low back pain: the Framingham Foot Study.

    Science.gov (United States)

    Menz, Hylton B; Dufour, Alyssa B; Riskowski, Jody L; Hillstrom, Howard J; Hannan, Marian T

    2013-12-01

    Abnormal foot posture and function have been proposed as possible risk factors for low back pain, but this has not been examined in detail. The objective of this study was to explore the associations of foot posture and foot function with low back pain in 1930 members of the Framingham Study (2002-05). Low back pain, aching or stiffness on most days was documented on a body chart. Foot posture was categorized as normal, planus or cavus using static weight-bearing measurements of the arch index. Foot function was categorized as normal, pronated or supinated using the centre of pressure excursion index derived from dynamic foot pressure measurements. Sex-specific multivariate logistic regression models were used to examine the associations of foot posture, foot function and asymmetry with low back pain, adjusting for confounding variables. Foot posture showed no association with low back pain. However, pronated foot function was associated with low back pain in women [odds ratio (OR) = 1.51, 95% CI 1.1, 2.07, P = 0.011] and this remained significant after adjusting for age, weight, smoking and depressive symptoms (OR = 1.48, 95% CI 1.07, 2.05, P = 0.018). These findings suggest that pronated foot function may contribute to low back symptoms in women. Interventions that modify foot function, such as orthoses, may therefore have a role in the prevention and treatment of low back pain.

  16. Comparative Anthropometry of the Foot

    Science.gov (United States)

    1982-12-01

    height, angular orientatior of metatarsal heads, lateral foot contour, plantar arch height, dorsal arch height, breadth of instep, instep girth...with ball length and ball girth, namely the dorsal and plantar arch heights, foot flare, and the angular orientation of the heads of the metatarsals, may...57. RIVARIATE TABE OF BALL OF FOOT CIRCUMFERENCE AND FOOT BREADTH FOR U. S. ARMY WOMEN (1977) FOOT BREADTH Centimeters 7.5 8.0 8.5 9.0 9.5 10.0 10.5

  17. 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.

  18. 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.

  19. The athlete's foot.

    Science.gov (United States)

    Resnik, S S; Lewis, L A; Cohen, B H

    1977-09-01

    In general, painful feet can affect the performance of an athlete in any sport. To prevent skin diseases of the feet, the "Athlete's Foot" should be kept clean and dry with toenails trimmed. Properly fitting athletic shoes should be worn to avoid the formation of blisters. Wearing of sandals in locker and shower rooms, which prevents intimate contact with infecting organisms, can alleviate many of the problems that affect the feet.

  20. The neuropathic diabetic foot.

    Science.gov (United States)

    Rathur, Haris M; Boulton, Andrew J M

    2007-01-01

    Diabetic foot problems are common throughout the world, and result in major medical, social and economic consequences for the patients, their families, and society. Foot ulcers are likely to be of neuropathic origin and, therefore, are eminently preventable. Individuals with the greatest risk of ulceration can easily be identified by careful clinical examination of their feet: education and frequent follow-up is indicated for these patients. When infection complicates a foot ulcer, the combination can be limb-threatening, or life-threatening. Infection is defined clinically, but wound cultures assist in identification of causative pathogens. Tissue specimens are strongly preferred to wound swabs for wound cultures. Antimicrobial therapy should be guided by culture results, and although such therapy may cure the infection, it does not heal the wound. Alleviation of the mechanical load on ulcers (offloading) should always be a part of treatment. Plantar neuropathic ulcers typically heal in 6 weeks with nonremovable casts, because pressure at the ulcer site is mitigated and compliance is enforced. The success of other approaches to offloading similarly depends on the patient's adherence to the strategy used for pressure relief.

  1. The diabetic foot.

    Science.gov (United States)

    Rathur, Haris M; Boulton, Andrew J M

    2007-01-01

    Diabetic foot problems are common throughout the world, resulting in major medical, social and economic consequences for the patients, their families, and society. Foot ulcers are more likely to be of neuropathic origin, and therefore eminently preventable. People at greatest risk of ulceration can easily be identified by careful clinical examination of the feet: education and frequent follow-up is indicated for these patients. When infection complicates a foot ulcer, the combination can be limb or life-threatening. Infection is defined clinically, but wound cultures assist in identifying the causative pathogens. Tissue specimens are strongly preferred to wound swabs for wound cultures. Antimicrobial therapy should be guided by culture results, and although such therapy may cure the infection, it does not heal the wound. Alleviation of the mechanical load on ulcers (offloading) should always be a part of treatment. Plantar neuropathic ulcers typically heal in 6 weeks with irremovable casting, because pressure at the ulcer site is mitigated and compliance is enforced. The success of other approaches to offloading similarly depends on the patients' adherence to the effectiveness of pressure relief.

  2. Chondroblastoma of the foot.

    Science.gov (United States)

    Fink, B R; Temple, H T; Chiricosta, F M; Mizel, M S; Murphey, M D

    1997-04-01

    A total of 322 cases of chondroblastoma were referred to the Armed Forces Institute of Pathology between 1960 and 1990. Ten additional cases of chondroblastoma were treated at Walter Reed Army Medical Center between 1985 and 1993. Forty-two of these involved the foot, two of which were treated at Walter Reed Army Medical Center. Patients with chondroblastoma of the foot were male in 35 (81%) cases, with a mean age of 25.5 years, which was significantly different from the mean age of 17.3 years in patients with chondroblastoma of the long bones (P Chondroblastoma of the foot is most commonly found in the posterior subchondral areas of the talus and calcaneus as well as in the calcaneal apophysis. Radiographically, the lesion was associated with an articular surface or apophyseal area in all cases and appeared radiolucent, with little to no matrix production. The margins were generally well defined. Cystic features were noted grossly and histologically in 24 (57%) specimens, a feature seen in only 21% of all chondroblastomas overall. Treatment consists of thorough curetting and bone grafting with good oncologic and functional results.

  3. [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.

  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. Predatory functional morphology in raptors: interdigital variation in talon size is related to prey restraint and immobilisation technique.

    Directory of Open Access Journals (Sweden)

    Denver W Fowler

    Full Text Available Despite the ubiquity of raptors in terrestrial ecosystems, many aspects of their predatory behaviour remain poorly understood. Surprisingly little is known about the morphology of raptor talons and how they are employed during feeding behaviour. Talon size variation among digits can be used to distinguish families of raptors and is related to different techniques of prey restraint and immobilisation. The hypertrophied talons on digits (D I and II in Accipitridae have evolved primarily to restrain large struggling prey while they are immobilised by dismemberment. Falconidae have only modest talons on each digit and only slightly enlarged D-I and II. For immobilisation, Falconini rely more strongly on strike impact and breaking the necks of their prey, having evolved a 'tooth' on the beak to aid in doing so. Pandionidae have enlarged, highly recurved talons on each digit, an adaptation for piscivory, convergently seen to a lesser extent in fishing eagles. Strigiformes bear enlarged talons with comparatively low curvature on each digit, part of a suite of adaptations to increase constriction efficiency by maximising grip strength, indicative of specialisation on small prey. Restraint and immobilisation strategy change as prey increase in size. Small prey are restrained by containment within the foot and immobilised by constriction and beak attacks. Large prey are restrained by pinning under the bodyweight of the raptor, maintaining grip with the talons, and immobilised by dismemberment (Accipitridae, or severing the spinal cord (Falconini. Within all raptors, physical attributes of the feet trade off against each other to attain great strength, but it is the variable means by which this is achieved that distinguishes them ecologically. Our findings show that interdigital talon morphology varies consistently among raptor families, and that this is directly correlative with variation in their typical prey capture and restraint strategy.

  9. Predatory functional morphology in raptors: interdigital variation in talon size is related to prey restraint and immobilisation technique.

    Science.gov (United States)

    Fowler, Denver W; Freedman, Elizabeth A; Scannella, John B

    2009-11-25

    Despite the ubiquity of raptors in terrestrial ecosystems, many aspects of their predatory behaviour remain poorly understood. Surprisingly little is known about the morphology of raptor talons and how they are employed during feeding behaviour. Talon size variation among digits can be used to distinguish families of raptors and is related to different techniques of prey restraint and immobilisation. The hypertrophied talons on digits (D) I and II in Accipitridae have evolved primarily to restrain large struggling prey while they are immobilised by dismemberment. Falconidae have only modest talons on each digit and only slightly enlarged D-I and II. For immobilisation, Falconini rely more strongly on strike impact and breaking the necks of their prey, having evolved a 'tooth' on the beak to aid in doing so. Pandionidae have enlarged, highly recurved talons on each digit, an adaptation for piscivory, convergently seen to a lesser extent in fishing eagles. Strigiformes bear enlarged talons with comparatively low curvature on each digit, part of a suite of adaptations to increase constriction efficiency by maximising grip strength, indicative of specialisation on small prey. Restraint and immobilisation strategy change as prey increase in size. Small prey are restrained by containment within the foot and immobilised by constriction and beak attacks. Large prey are restrained by pinning under the bodyweight of the raptor, maintaining grip with the talons, and immobilised by dismemberment (Accipitridae), or severing the spinal cord (Falconini). Within all raptors, physical attributes of the feet trade off against each other to attain great strength, but it is the variable means by which this is achieved that distinguishes them ecologically. Our findings show that interdigital talon morphology varies consistently among raptor families, and that this is directly correlative with variation in their typical prey capture and restraint strategy.

  10. Relationship between static foot posture and foot mobility

    Directory of Open Access Journals (Sweden)

    McPoil Thomas G

    2011-01-01

    Full Text Available Abstract Background It is not uncommon for a person's foot posture and/or mobility to be assessed during a clinical examination. The exact relationship, however, between static posture and mobility is not known. Objective The purpose of this study was to determine the degree of association between static foot posture and mobility. Method The static foot posture and foot mobility of 203 healthy individuals was assessed and then analyzed to determine if low arched or "pronated" feet are more mobile than high arched or "supinated" feet. Results The study demonstrated that those individuals with a lower standing dorsal arch height and/or a wider standing midfoot width had greater mobility in their foot. In addition, those individuals with higher Foot Posture Index (FPI values demonstrated greater mobility and those with lower FPI values demonstrated less mobility. Finally, the amount of foot mobility that an individual has can be predicted reasonably well using either a 3 or 4 variable linear regression model. Conclusions Because of the relationship between static foot posture and mobility, it is recommended that both be assessed as part of a comprehensive evaluation of a individual with foot problems.

  11. 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.

  12. 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.

  13. 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.

  14. 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…

  15. 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)

  16. 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…

  17. 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)

  18. 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…

  19. 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...

  20. [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.

  1. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  3. 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…

  4. 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

  5. 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

  6. 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...

  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.

    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

  8. 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

  9. 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.

  10. 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.

  11. 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.

  12. 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.

  13. [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.

  14. American Orthopaedic Foot and Ankle Society

    Science.gov (United States)

    ... Statements Publications Foot & Ankle International (FAI) Foot & Ankle Orthopaedics (FAO) In~Stride Newsletter News Center Press Releases ... the best possible care, see a foot & ankle ORTHOPAEDIC surgeon. Find one in your area here. Having ...

  15. 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

  16. Foot-and-mouth disease

    DEFF Research Database (Denmark)

    Belsham, Graham; Charleston, Bryan; Jackson, Terry

    2009-01-01

    Foot-and-mouth disease is an economically important, highly contagious, disease of cloven-hoofed animals characterized by the appearance of vesicles (blisters) on the feet and in and around the mouth. The causative agent, foot-and-mouth disease virus, was the first mammalian virus to be discovered...

  17. Sesamoid Injuries in the Foot

    Science.gov (United States)

    ... the shoe may be prescribed for long-term treatment of sesamoiditis to balance the pressure placed on the ball of the foot. When Is Surgery Needed? When sesamoid injuries fail to respond to nonsurgical treatment, surgery may be required. The foot and ankle ...

  18. Malignant Melanoma of the Foot

    Science.gov (United States)

    ... page. Please enable Javascript in your browser. Malignant Melanoma of the Foot What Is Malignant Melanoma? Melanoma is a cancer that begins in the ... people of all age groups, even the young. Melanoma in the Foot Melanoma that occurs in the ...

  19. Foot-and-mouth disease

    DEFF Research Database (Denmark)

    Belsham, Graham; Charleston, Bryan; Jackson, Terry;

    2009-01-01

    Foot-and-mouth disease is an economically important, highly contagious, disease of cloven-hoofed animals characterized by the appearance of vesicles (blisters) on the feet and in and around the mouth. The causative agent, foot-and-mouth disease virus, was the first mammalian virus to be discovered...

  20. 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.

  1. 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.

  2. The Effect of Taping on Foot Structure, Functional Foot Stability and Running Gait Patterns of the Foot

    Institute of Scientific and Technical Information of China (English)

    Malia Ho; Tsai Djun; John Cher Chay Tan

    2015-01-01

    Running related foot injuries are associated with excessive foot movements due to malaligned foot structure and poor functional foot stability. Clinicians tape the foot to alleviate pain and prevent further injuries, whilst allowing the athlete to continue training. However, the effect of taping is not conclusive. The purpose of this study is to investigate if taping effectively improves foot structure, functional foot stability and reduces excessive foot movements during running. Twenty-two subjects had their foot structure identified as: fiat foot stable, fiat foot unstable and normal arched unstable according to the FPI (foot posture index) and the Modified Romberg's Test with the BESS (balance error scoring system) criteria. The subjects ran on an instrumented treadmill barefooted with their feet taped and untaped. Running kinetic and kinematic data were collected and analysed using a paired t-test and 3x2 ANOVA. Taping improved foot structure but not functional foot stability. During running, taping significantly reduced rearfoot eversion. Taping increased the loading rate in the fiat foot and normal arched unstable groups but reduced the loading rate for the flat foot stable group. Implication on the appropriate use of foot taping was discussed.

  3. 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.

  4. 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.

  5. 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...

  6. 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.

  7. Complications of the diabetic foot.

    Science.gov (United States)

    Kim, Paul J; Steinberg, John S

    2013-12-01

    The diabetic foot is at high risk for complications because of its role in ambulation. Peripheral neuropathy and peripheral vascular disease can lead to chronic foot ulcers, which are at high risk for infection, in part attributable to areas of high pressure caused by lack of tolerance of the soft tissue and bone and joint deformity. If left untreated, infection and ischemia lead to tissue death, culminating in amputation. Treatment strategies include antibiosis, topical therapies, offloading, debridement, and surgery. A multidisciplinary team approach is necessary in the prevention and treatment of complications of the diabetic foot.

  8. Foot abnormalities of wild birds

    Science.gov (United States)

    Herman, C.M.; Locke, L.N.; Clark, G.M.

    1962-01-01

    The various foot abnormalities that occur in birds, including pox, scaly-leg, bumble-foot, ergotism and freezing are reviewed. In addition, our findings at the Patuxent Wildlife Research Center include pox from dove, mockingbird, cowbird, grackle and several species of sparrows. Scaly-leg has been particularly prevalent on icterids. Bumble foot has been observed in a whistling swan and in a group of captive woodcock. Ergotism is reported from a series of captive Canada geese from North Dakota. Several drug treatments recommended by others are presented.

  9. Characterizing multisegment foot kinematics during gait in diabetic foot patients

    Directory of Open Access Journals (Sweden)

    Denti Paolo

    2009-10-01

    Full Text Available Abstract Background The prevalence of diabetes mellitus has reached epidemic proportions, this condition may result in multiple and chronic invalidating long term complications. Among these, the diabetic foot, is determined by the simultaneous presence of both peripheral neuropathy and vasculopathy that alter the biomechanics of the foot with the formation of callosity and ulcerations. To diagnose and treat the diabetic foot is crucial to understand the foot complex kinematics. Most of gait analysis protocols represent the entire foot as a rigid body connected to the shank. Nevertheless the existing multisegment models cannot completely decipher the impairments associated with the diabetic foot. Methods A four segment foot and ankle model for assessing the kinematics of the diabetic foot was developed. Ten normal subjects and 10 diabetics gait patterns were collected and major sources of variability were tested. Repeatability analysis was performed both on a normal and on a diabetic subject. Direct skin marker placement was chosen in correspondence of 13 anatomical landmarks and an optoelectronic system was used to collect the data. Results Joint rotation normative bands (mean plus/minus one standard deviation were generated using the data of the control group. Three representative strides per subject were selected. The repeatability analysis on normal and pathological subjects results have been compared with literature and found comparable. Normal and pathological gait have been compared and showed major statistically significant differences in the forefoot and midfoot dorsi-plantarflexion. Conclusion Even though various biomechanical models have been developed so far to study the properties and behaviour of the foot, the present study focuses on developing a methodology for the functional assessment of the foot-ankle complex and for the definition of a functional model of the diabetic neuropathic foot. It is, of course, important to evaluate

  10. 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

  11. 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...

  12. 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.

  13. 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...

  14. 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.

  15. 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.

  16. 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.

  17. 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.

  18. 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

  19. Broken Ankle/Broken Foot

    Science.gov (United States)

    ... so that your doctor can examine your gait. Imaging tests Not all foot and ankle injuries require ... an orthopedic surgeon may need to use pins, plates or screws to maintain proper position of your ...

  20. Avoiding foot complications in diabetes

    African Journals Online (AJOL)

    to pain, heat, cold, pressure and proprioception allows increased callus formation at pressure points. This usually precedes an ulcer. Autonomic neuropathy causes a warm foot with bulging veins ... inadequate individual or family awareness.

  1. Imaging the diabetic foot

    Energy Technology Data Exchange (ETDEWEB)

    Gold, R.H. [Dept. of Radiological Sciences, UCLA School of Medicine, Los Angeles, CA (United States); Tong, D.T.F. [Dept. of Radiological Sciences, UCLA School of Medicine, Los Angeles, CA (United States); Crim, J.R. [Durham Radiology Associates, Durham, NC (United States); Seeger, L.L. [Dept. of Radiological Sciences, UCLA School of Medicine, Los Angeles, CA (United States)

    1995-11-01

    Early and accurate diagnosis of infection or neuropathy of the diabetic foot is the key to successful management. Angiopathy leads to ischemia which, in combination with peripheral neuropathy, predisposes to pedal skin ulceration, the precursor of osteomyelitis. Chronic hyperglycemia promotes production of glycosylated end products which accumulate on endothelial proteins, causing ischemia of the vasa nervorum. When combined with axonal degeneration of the sensory nerves, the result is hypertrophic neuroarthropathy. Should the sympathetic nerve fibers also be damaged, the resultant loss of vasoconstrictive impulses leads to hyperemia and atrophic neuroarthropathy. Plain radiography, although less sensitive than radionuclide, magnetic resonance (MR), and computed tomographic examinations, should be the initial procedure for imaging suspected osteomyelitis in the diabetic patient. If the radiographs are normal but the clinical suspicion of osteomyelitis is strong, a three-phase {sup 99m}Tc-MDP scan or MR imaging is recommended. An equivocal {sup 99m}Tc-MDP scan should be followed by MR imaging. To exclude osteomyelitis at a site of neuroarthropathy, a {sup 111}In white blood cell scan is preferable. To obtain a specimen of bone for bacteriological studies, percutaneous core biopsy is the procedure of choice, with the entrance of the needle well beyond the edge of the subjacent ulcer. (orig.)

  2. Hand, Foot, and Mouth Disease

    Centers for Disease Control (CDC) Podcasts

    2013-08-08

    Hand, foot, and mouth disease is a contagious illness that mainly affects children under five. In this podcast, Dr. Eileen Schneider talks about the symptoms of hand, foot, and mouth disease, how it spreads, and ways to help protect yourself and your children from getting infected with the virus.  Created: 8/8/2013 by National Center for Immunization and Respiratory Diseases (NCIRD).   Date Released: 8/8/2013.

  3. 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.

  4. 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.

  5. 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.

  6. Illiteracy and diabetic foot complications.

    Science.gov (United States)

    Al-Kaabi, Juma M; Al Maskari, Fatma; Cragg, Paul; Afandi, Bachar; Souid, Abdul-Kader

    2015-12-01

    Diabetes is especially common in the United Arab Emirates. Its complications in patients residing in the region have yet to be fully explored. This study reports on foot problems in our diabetic patients, with emphasis on the impact of illiteracy on foot care and complications due to diabetes. Adults were randomly recruited from the Diabetes Center at Tawam-John Hopkins affiliated hospital. A questionnaire addressing foot care and problems was completed for all patients. In addition, an examination was performed by a trained nurse, an endocrinologist, and a podiatrist. Four hundred twenty-two adults with type 2 (93%) or type 1 (7%) diabetes were enrolled; 67% were females. Patients' mean age was 52 ± 13 years and duration of diabetes ≥ 1 year. Illiterate patients were 51% and were less likely to practice foot care (p=0.002), recognize foot risk factors (p=0.004), use proper footwear (p=0.010), and being physically active (pIlliteracy invoked significant challenges to diabetic attentiveness and imposed increased foot complications. Physicians should realize that illiterate patients are vulnerable and require effective strategies to improve their education about the disease and reduce their diabetic complications. Copyright © 2015 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

  7. 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.

  8. 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

  9. 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.

  10. 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.

  11. 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

  12. 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

  13. 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

  14. Hand and foot pressures in the aye-aye (Daubentonia madagascariensis) reveal novel biomechanical trade-offs required for walking on gracile digits.

    Science.gov (United States)

    Kivell, Tracy L; Schmitt, Daniel; Wunderlich, Roshna E

    2010-05-01

    Arboreal animals with prehensile hands must balance the complex demands of bone strength, grasping and manipulation. An informative example of this problem is that of the aye-aye (Daubentonia madagascariensis), a rare lemuriform primate that is unusual in having exceptionally long, gracile fingers specialized for foraging. In addition, they are among the largest primates to engage in head-first descent on arboreal supports, a posture that should increase loads on their gracile digits. We test the hypothesis that aye-ayes will reduce pressure on their digits during locomotion by curling their fingers off the substrate. This hypothesis was tested using simultaneous videographic and pressure analysis of the hand, foot and digits for five adult aye-ayes during horizontal locomotion and during ascent and descent on a 30 degrees instrumented runway. Aye-ayes consistently curled their fingers during locomotion on all slopes. When the digits were in contact with the substrate, pressures were negligible and significantly less than those experienced by the palm or pedal digits. In addition, aye-ayes lifted their hands vertically off the substrate instead of 'toeing-off' and descended head-first at significantly slower speeds than on other slopes. Pressure on the hand increased during head-first descent relative to horizontal locomotion but not as much as the pressure increased on the foot during ascent. This distribution of pressure suggests that aye-ayes shift their weight posteriorly during head-first descent to reduce loads on their gracile fingers. This research demonstrates several novel biomechanical trade-offs to deal with complex functional demands on the mammalian skeleton.

  15. 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.

  16. Bacteriology of diabetic foot lesions.

    Science.gov (United States)

    Yoga, R; Khairul, A; Sunita, K; Suresh, C

    2006-02-01

    Infection plays a pivotal role in enhancing a diabetic foot at risk toward amputation. Effective antibiotic therapy against the offending pathogens is an important component of treatment of diabetic foot infections. Recognition of the pathogen is always difficult as the representative deep tissue sample for culture is surrounded by ulcer surface harbouring colonies of organisms frequently labelled as skin commensals. The emergent of resistant strains represents a compounding problem standing against efforts to prevent amputation. This study was undertaken to identify the pathogens associated with diabetic foot infection in terms of their frequency and sensitivity against certain commonly used antibiotics. Forty-four consecutive patients with open diabetic foot infections had wound swab taken for culture and sensitivity testing. Cultures positive were observed in 89% of the cases with Staphylococcus aureus, Klebsiella pneumoniae, Pseudomonas aeroginosa encountered in 20%, 14% and 14% of cases respectively. Mixed growths were isolated in 6% of cultures. All Staphylcoccus aureus isolates were resistant to Penicillin but 80% were sensitive to Erythromycin and Co-trimoxazole. Klebsiella pneumoniae isolates were sensitive to Methicillin and Gentamycin in 80% and 60% of cases respectively, and resistant to Ampicillin and Ceftazidime in 83% and 50% respectively. All Pseudomonas aeroginosa isolates were sensitive to Amikacin and Ciprofloxacin but 50% were resistant to Gentamycin. There was no single antibiotic possessing good coverage for all common organisms isolated from diabetic foot lesions. Staphylococcus aureus remains the predominant cause of diabetic foot infections followed by Klebsiela pneumonia and Pseudomonas aeroginosa. Most infections are monomicrobial. The emergence of multiresistant organisms is a worrying feature in diabetic foot infections.

  17. 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.

  18. 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.

  19. 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.

  20. 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...

  1. 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

  2. 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.

  3. 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.

  4. [Operative treatment of diabetic foot].

    Science.gov (United States)

    Hintermann, B

    1999-07-08

    The majority of diabetic foot ulcers are the results of repetitive pressure that exceeds the threshold of soft-tissue tolerance, leading to mechanical destruction of the tissue. Progression of plantar ulcers can rapidly lead to osteomyelitis that may result in loss of the foot through amputation. In order to prevent such a disaster, surgical treatment should be taken into consideration when conservative treatment remains without success. The goal of surgical treatment of an infected ulcer is debridement of the soft-tissue and removal of the underlying pressure by careful bone resection or correction of a deformity by arthrodesis. Various authors have recently reported successful surgical reconstruction of neuroarthropathic foot deformity and instability. Apparently arthrodesis is a viable alternative to amputation for patients with unstable deformity or recurrent ulceration. Proper preoperative evaluation is mandatory. The indications are not well defined yet.

  5. The Charcot foot in diabetes.

    Science.gov (United States)

    Rogers, Lee C; Frykberg, Robert G; Armstrong, David G; Boulton, Andrew J M; Edmonds, Michael; Van, Georges Ha; Hartemann, Agnes; Game, Frances; Jeffcoate, William; Jirkovska, Alexandra; Jude, Edward; Morbach, Stephan; Morrison, William B; Pinzur, Michael; Pitocco, Dario; Sanders, Lee; Wukich, Dane K; Uccioli, Luigi

    2011-09-01

    The diabetic Charcot foot syndrome is a serious and potentially limb-threatening lower-extremity complication of diabetes. First described in 1883, this enigmatic condition continues to challenge even the most experienced practitioners. Now considered an inflammatory syndrome, the diabetic Charcot foot is characterized by varying degrees of bone and joint disorganization secondary to underlying neuropathy, trauma, and perturbations of bone metabolism. An international task force of experts was convened by the American Diabetes Association and the American Podiatric Medical Association in January 2011 to summarize available evidence on the pathophysiology, natural history, presentations, and treatment recommendations for this entity.

  6. Design and Analysis of New Prosthetic Foot.

    Directory of Open Access Journals (Sweden)

    Kadhim K.Al-Kinani,MSc

    2007-01-01

    Full Text Available There is a variety of artificial foot designs variable for use with prosthetic legs . Most of the design can be divided into two classes, articulated and non-articulated feet. one common non-articulated foot is the SACH . The solid ankle cushion heel foot referred to as the SACH foot has a rigid keelOne key or the key factor in designing a new prosthesis is in the analysis of a patients response This view is the most important because if the foot does not provide functional , practical or cosmetically acceptable characteristics the patient will not feel comfortable with the prosthesis , therefore design and manufacturing a new foot is essential, this foot made from polyethylene, its different shape and characteristics The characteristics deemed important by patients in achieving natural gait motion include:Dorsiflexion Energy return Fatigue test In this study, including all these characteristics test, design fatigue foot tester according to ISO 10328 and design new foot .Also, the testometric crosshead was modified to find dorsiflexion angle and energy return .The fatigue criteria for polymer was proposed, in mathematical solution. Finally , the characteristics of SACH foot was compared with new foot by mathematical solution and used visual basic program and experimental method by different tests. From these test that the new foot is better than SACH foot for all test .

  7. Diabetic foot ulcers: practical treatment recommendations.

    Science.gov (United States)

    Edmonds, Michael

    2006-01-01

    When treating diabetic foot ulcers it is important to be aware of the natural history of the diabetic foot, which can be divided into five stages: stage 1, a normal foot; stage 2, a high risk foot; stage 3, an ulcerated foot; stage 4, an infected foot; and stage 5, a necrotic foot. This covers the entire spectrum of foot disease but emphasises the development of the foot ulcer as a pivotal event in stage 3, which demands urgent and aggressive management. Diabetic foot care in all stages needs multidisciplinary management to control mechanical, wound, microbiological, vascular, metabolic and educational aspects. Achieving good metabolic control of blood glucose, lipids and blood pressure is important in each stage, as is education to teach proper foot care appropriate for each stage. Ideally, it is important to prevent the development of ulcers in stages 1 and 2. In stage 1, the normal foot, it is important to encourage the use of suitable footwear, and to educate the patient to promote healthy foot care and footwear habits. In stage 2, the foot has developed one or more of the following risk factors for ulceration: neuropathy, ischaemia, deformity, swelling and callus. The majority of deformities can be accommodated in special footwear and as callus is an important precursor of ulceration it should be treated aggressively, especially in the neuropathic foot. In stage 3, ulcers can be divided into two distinct entities: those in the neuropathic foot and those in the neuroischaemic foot. In the neuropathic foot, ulcers commonly develop on the plantar surface of the foot and the toes, and are associated with neglected callus and high plantar pressures. In the neuroischaemic foot, ulcers are commonly seen around the edges of the foot, including the apices of the toes and back of the heel, and are associated with trauma or wearing unsuitable shoes. Ulcers in stage 3 need relief of pressure (mechanical control), sharp debridement and dressings (wound control), and

  8. 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…

  9. 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…

  10. 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.…

  11. 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.

  12. 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…

  13. 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…

  14. 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…

  15. 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.…

  16. 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…

  17. 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…

  18. 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...

  19. 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

  20. 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…

  1. 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.

  2. 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

  3. 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…

  4. 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…

  5. 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.…

  6. 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.

  7. 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.

  8. 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.

  9. 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.

  10. 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.

  11. 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

  12. 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.

  13. 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.

  14. 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

  15. 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.

  16. 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.

  17. Diabetic Foot - Multiple Languages: MedlinePlus

    Science.gov (United States)

    ... Are Here: Home → Multiple Languages → All Health Topics → Diabetic Foot URL of this page: https://medlineplus.gov/languages/ ... V W XYZ List of All Topics All Diabetic Foot - Multiple Languages To use the sharing features on ...

  18. 130 DIABETIC FOOT ULCERS: CURRENT TRENDS IN ...

    African Journals Online (AJOL)

    drclement

    achieved in the treatment of diabetic foot ulcers in ... Fig II: WAGNER CLASSIFICATION OF DIABETIC FOOT ULCERS. Grade 0 .... to surgeries for correcting deformities .... Seamless socks and socks with flat, unobtrusive, soft seams should.

  19. Find an Orthopaedic Foot and Ankle MD/DO

    Science.gov (United States)

    ... Content AOFAS / FootCareMD / Find a Surgeon Find an Orthopaedic Foot & Ankle Surgeon Page Content The Orthopaedic Distinction Who are Orthopaedic Foot & Ankle Surgeons? Orthopaedic foot and ankle surgeons ...

  20. 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

  1. An overview of the Charcot foot pathophysiology

    OpenAIRE

    Öğüt, Tahir; Kaynak, Gökhan; Birsel, Olgar; Güven, Mehmet Fatih

    2013-01-01

    Charcot arthropathy of the foot is a rare but devastating complication of diabetes that remains to be a challenging issue for the foot and ankle surgeons. Charcot foot fails to be an obvious diagnostic option that comes to mind, even in a pathognomonic clinical appearance. The rarity of the disorder, more common pathologies that mimic the condition, and the self-limiting prognosis deviate the clinician from the right diagnosis. The clinical challenges in the diagnosis of Charcot foot require ...

  2. Foot Health Facts for Athletes

    Science.gov (United States)

    ... as basketball, can lead to tears and even ruptures of the Achilles tendon. These conditions should be followed by a foot and ankle surgeon. Heel pain —This condition is most often caused by plantar fasciitis, although other things, such as stress fractures or ...

  3. DIABETIC FOOT ULCERS MICROBIOLOGICAL STUDY

    Directory of Open Access Journals (Sweden)

    P. Rajagopal

    2016-08-01

    Full Text Available BACKGROUND AND OBJECTIVES Infections of all types are more common in patients with diabetes, on the basis of outcome of retrospective study in Canada. Many types of infections are very common in diabetic than non-diabetic patients. Foot is the most common site. Diabetic foot infections range from mild infections to limb threatening conditions. Most require emergency medical attention. Diabetic foot infection is a global burden and projected to increase from 246 million people to over 380 million people by the year 2025. Many people with diabetes develop complications that seriously affect their quality and length of life. Lower limb complications are common, particularly foot ulcers and gangrene. Development of these complications is attributed to individual risk factors, poverty, racial and ethnic differences, and quality of local and national health care systems. The wide variations noted suggest that best practices in low incidence areas could easily be adapted in high incidence areas to reduce the burden of complications. Almost every infection begins in a wound, often as neuropathic ulceration or a traumatic break in the skin. Infections that begin as a small problem may progress to involve soft tissue, bones and joints. Because of these morbidity and occasional mortality by these foot infections several authoritative groups have recently developed guidelines for assessing and treating diabetic foot. METHODOLOGY 100 Diabetic patients with foot ulcers were admitted and wounds were classified using wagner’s classification. Pus was sent for culture and sensitivity and treated accordingly. RESULTS In our study the most common organism cultured from the wound with diabetes mellitus was staphylococcus. The most sensitive drug for these organisms was found to be chloramphenicol on most occasions. CONCLUSION The rationale of pus culture and sensitivity is not only to definitively treat the diabetic wound after the culture sensitivity report is

  4. 24 CFR 3285.312 - Footings.

    Science.gov (United States)

    2010-04-01

    ... MODEL MANUFACTURED HOME INSTALLATION STANDARDS Foundations § 3285.312 Footings. (a) Materials approved... density. A footing must support every pier. Footings are to be either: (1) Concrete. (i) Four inch nominal... requirements when frame blocking only is used. 2. In addition to blocking required by § 3285.311, see Table...

  5. 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

  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. 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

  8. Clinical examination and foot pressure analysis of diabetic foot: Prospective analytical study in Indian diabetic patients.

    Directory of Open Access Journals (Sweden)

    Harshanand Popalwar

    2016-03-01

    Conclusion: Meticulous clinical examination can easily identify diabetic neuropathy and related pathological complications of diabetic foot. This shall help for early diagnosis and prevention of diabetic foot complications. Foot pressure analysis can be useful tool to screen patients of diabetic foot for abnormal high pressure point areas and can predict future risk of ulceration due to high foot pressure. This study states findings in Indian diabetic patients. [Natl J Med Res 2016; 6(1.000: 17-22

  9. Reliability and normative values of the foot line test: a technique to assess foot posture

    DEFF Research Database (Denmark)

    Brushøj, C; Larsen, Klaus; Nielsen, MB;

    2007-01-01

    STUDY DESIGN: Test-retest reliability. OBJECTIVE: To examine the reliability and report normative values of a novel test, the foot line test (FLT), to describe foot morphology. BACKGROUND: Numerous foot examinations are performed each day, but most existing examination techniques have considerable......). There was no significant association between foot size and FLT values. CONCLUSION: The FLT is a reproducible technique to assess foot posture....

  10. 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.

  11. 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.

  12. 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.

  13. 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...

  14. 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...

  15. 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.

  16. 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.

  17. 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.

  18. 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.

  19. 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.

  20. [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.

  1. 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.

  2. 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.

  3. 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

  4. 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.

  5. 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.

  6. [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

  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

    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

  8. 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.

  9. Weigh-in-motion scale with foot alignment features

    Energy Technology Data Exchange (ETDEWEB)

    Abercrombie, Robert Knox; Richardson, Gregory David; Scudiere, Matthew Bligh

    2013-03-05

    A pad is disclosed for use in a weighing system for weighing a load. The pad includes a weighing platform, load cells, and foot members. Improvements to the pad reduce or substantially eliminate rotation of one or more of the corner foot members. A flexible foot strap disposed between the corner foot members reduces rotation of the respective foot members about vertical axes through the corner foot members and couples the corner foot members such that rotation of one corner foot member results in substantially the same amount of rotation of the other corner foot member. In a strapless variant one or more fasteners prevents substantially all rotation of a foot member. In a diagonal variant, a foot strap extends between a corner foot member and the weighing platform to reduce rotation of the foot member about a vertical axis through the corner foot member.

  10. Weigh-in-motion scale with foot alignment features

    Energy Technology Data Exchange (ETDEWEB)

    Abercrombie, Robert Knox; Richardson, Gregory David; Scudiere, Matthew Bligh

    2013-03-05

    A pad is disclosed for use in a weighing system for weighing a load. The pad includes a weighing platform, load cells, and foot members. Improvements to the pad reduce or substantially eliminate rotation of one or more of the corner foot members. A flexible foot strap disposed between the corner foot members reduces rotation of the respective foot members about vertical axes through the corner foot members and couples the corner foot members such that rotation of one corner foot member results in substantially the same amount of rotation of the other corner foot member. In a strapless variant one or more fasteners prevents substantially all rotation of a foot member. In a diagonal variant, a foot strap extends between a corner foot member and the weighing platform to reduce rotation of the foot member about a vertical axis through the corner foot member.

  11. 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)

  12. 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)

  13. 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...

  14. 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.

  15. 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.

  16. 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.

  17. 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.

  18. 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

  19. 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.

  20. 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.

  1. 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.

  2. 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. ...

  3. 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.

  4. 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.

  5. [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.

  6. Diabetic foot ulcer: assessment and management.

    Science.gov (United States)

    Saraogi, Ravi Kant

    2008-02-01

    Diabetic foot ulcer is a rising health problem with rising prevalence of diabetes. It is the most important cause of non-traumatic foot amputations. Diabetic foot ulcers are primarily due to neuropathy and/or ischaemia, and are frequently complicated by infection. Up to 85% of all diabetic foot related problems are preventable through a combination of good foot care and appropriate education for patients and healthcare providers. The holistic care of diabetic foot ulcer patients requires a multidisciplinary team approach. Apart from blood sugar control, treatment of ulcer involves debridement, offloading, appropriate dressings, vascular maintenance and infection control. Use of adjunctive treatments such as various growth factors, skin replacement dressings and vacuum assisted closure will accelerate healing in selected cases.

  7. Foot Plantar Pressure Measurement System: A Review

    Directory of Open Access Journals (Sweden)

    Yufridin Wahab

    2012-07-01

    Full Text Available Foot plantar pressure is the pressure field that acts between the foot and the support surface during everyday locomotor activities. Information derived from such pressure measures is important in gait and posture research for diagnosing lower limb problems, footwear design, sport biomechanics, injury prevention and other applications. This paper reviews foot plantar sensors characteristics as reported in the literature in addition to foot plantar pressure measurement systems applied to a variety of research problems. Strengths and limitations of current systems are discussed and a wireless foot plantar pressure system is proposed suitable for measuring high pressure distributions under the foot with high accuracy and reliability. The novel system is based on highly linear pressure sensors with no hysteresis.

  8. Narrative review: Diabetic foot and infrared thermography

    Science.gov (United States)

    Hernandez-Contreras, D.; Peregrina-Barreto, H.; Rangel-Magdaleno, J.; Gonzalez-Bernal, J.

    2016-09-01

    Diabetic foot is one of the major complications experienced by diabetic patients. An early identification and appropriate treatment of diabetic foot problems can prevent devastating consequences such as limb amputation. Several studies have demonstrated that temperature variations in the plantar region can be related to diabetic foot problems. Infrared thermography has been successfully used to detect complication related to diabetic foot, mainly because it is presented as a rapid, non-contact and non-invasive technique to visualize the temperature distribution of the feet. In this review, an overview of studies that relate foot temperature with diabetic foot problems through infrared thermography is presented. Through this research, it can be appreciated the potential of infrared thermography and the benefits that this technique present in this application. This paper also presents the different methods for thermogram analysis and the advantages and disadvantages of each one, being the asymmetric analysis the method most used so far.

  9. Foot kinematics and kinetics during adolescent gait.

    Science.gov (United States)

    MacWilliams, Bruce A; Cowley, Matthew; Nicholson, Diane E

    2003-06-01

    Gait analysis models typically analyze the ankle joint complex and treat the foot as a rigid segment. Such models are inadequate for clinical decision making for patients with foot impairments. While previous multisegment foot models have been presented, no comprehensive kinematic and kinetic databases for normal gait exist. This study provides normative foot joint angles, moments and powers during adolescent gait. Eighteen subjects were evaluated using 19 retroreflective markers, six cameras, a pressure platform and a force plate. A nine-segment model determined 3D angles, 3D moments, and powers in eight joints or joint complexes. A complete sets of sagittal, coronal and frontal plane results are presented. Results indicate that single link models of the foot significantly overestimate ankle joint powers during gait. Understanding normal joint kinematics and kinetics during gait will provide a baseline for documenting impairments in patients with foot disorders.

  10. 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.

  11. [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.

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. 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.

  17. Priorities in offloading the diabetic foot.

    Science.gov (United States)

    Bus, Sicco A

    2012-02-01

    Biomechanical factors play an important role in diabetic foot disease. Reducing high foot pressures (i.e. offloading) is one of the main goals in healing and preventing foot ulceration. Evidence-based guidelines show the strong association between the efficacy to offload the foot and clinical outcome. However, several aspects related to offloading are underexposed. First, in the management of foot complications, offloading is mostly studied as a single entity, whereas it should be analysed in a broader perspective of contributing factors to better predict clinical outcome. This includes assessment of patient behavioural factors such as type and intensity of daily physical activity and adherence to prescribed treatment. Second, a large gap exists between evidence-based recommendations and clinical practice in the use of offloading for ulcer treatment, and this gap needs to be bridged. Possible ways to achieve this are discussed in this article. Third, our knowledge about the efficacy and role of offloading in treating complicated and non-plantar neuropathic foot ulcers needs to be expanded because these ulcers currently dominate presentation in multidisciplinary foot practice. Finally, foot ulcer prevention is underexposed when compared with ulcer treatment. Prevention requires a larger focus, in particular regarding the efficacy of therapeutic footwear and its relative role in comparison with other preventative strategies. These priorities need the attention of clinicians, scientists and professional societies to improve our understanding of offloading and to improve clinical outcome in the management of the diabetic foot.

  18. Prevention and treatment of diabetic foot ulcers.

    Science.gov (United States)

    Lim, Jonathan Zhang Ming; Ng, Natasha Su Lynn; Thomas, Cecil

    2017-03-01

    The rising prevalence of diabetes estimated at 3.6 million people in the UK represents a major public health and socioeconomic burden to our National Health Service. Diabetes and its associated complications are of a growing concern. Diabetes-related foot complications have been identified as the single most common cause of morbidity among diabetic patients. The complicating factor of underlying peripheral vascular disease renders the majority of diabetic foot ulcers asymptomatic until latter evidence of non-healing ulcers become evident. Therefore, preventative strategies including annual diabetic foot screening and diabetic foot care interventions facilitated through a multidisciplinary team have been implemented to enable early identification of diabetic patients at high risk of diabetic foot complications. The National Diabetes Foot Care Audit reported significant variability and deficiencies of care throughout England and Wales, with emphasis on change in the structure of healthcare provision and commissioning, improvement of patient education and availability of healthcare access, and emphasis on preventative strategies to reduce morbidities and mortality of this debilitating disease. This review article aims to summarise major risk factors contributing to the development of diabetic foot ulcers. It also considers the key evidence-based strategies towards preventing diabetic foot ulcer. We discuss tools used in risk stratification and classifications of foot ulcer.

  19. [Hand, foot and mouth disease].

    Science.gov (United States)

    Barriere, H; Berger, M; Billaudel, S

    1976-11-16

    Two characteristic cases encountered in young adults led the authors to present the hand foot and mouth syndrome. They report the characteristic distribution and vesicular appearance of the lesions. The course was benign. The viral origin of the disease was more or less easily confirmed by cell culture, inoculation in new born mice and demonstration of antibodies. Usually the virus was a Coxackie A 16. However in one of the authors cases, an Echo 11 was demonstrated. The apparent rareness of the disease may be explained by lack of recognition.

  20. 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.

  1. 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.

  2. 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).

  3. 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.

  4. A new method to normalize plantar pressure measurements for foot size and foot progression angle.

    NARCIS (Netherlands)

    Keijsers, N.L.; Stolwijk, N.M.; Nienhuis, B.; Duysens, J.E.J.

    2009-01-01

    Plantar pressure measurement provides important information about the structure and function of the foot and is a helpful tool to evaluate patients with foot complaints. In general, average and maximum plantar pressure of 6-11 areas under the foot are used to compare groups of subjects. However,

  5. Classification of diabetic foot ulcers.

    Science.gov (United States)

    Game, Frances

    2016-01-01

    It is known that the relative importance of factors involved in the development of diabetic foot problems can vary in both their presence and severity between patients and lesions. This may be one of the reasons why outcomes seem to vary centre to centre and why some treatments may seem more effective in some people than others. There is a need therefore to classify and describe lesions of the foot in patients with diabetes in a manner that is agreed across all communities but is simple to use in clinical practice. No single system is currently in widespread use, although a number have been published. Not all are well validated outside the system from which they were derived, and it has not always been made clear the clinical purposes to which such classifications should be put to use, whether that be for research, clinical description in routine clinical care or audit. Here the currently published classification systems, their validation in clinical practice, whether they were designed for research, audit or clinical care, and the strengths and weaknesses of each are explored.

  6. The madura foot: looking deep.

    Science.gov (United States)

    Venkatswami, Sandhya; Sankarasubramanian, Anandan; Subramanyam, Shobana

    2012-03-01

    "Mycetoma" means a fungal tumor. Mycetoma is a chronic, granulomatous, subcutaneous tissue infection caused by both bacteria (actinomycetoma) and fungi (eumycetoma). This chronic infection was termed Madura foot and eventually mycetoma, owing to its etiology. Inoculation commonly follows minor trauma, predominantly to the foot and hence is seen more among the barefoot-walking populations, common among adult males aged 20 to 50 years. The hallmark triad of the disease includes tumefaction, fistulization of the abscess, and extrusion of colored grains. The color of these extruded grains in the active phase of the disease offers a clue to diagnosis. Radiology, ultrasonology, cytology, histology, immunodiagnosis, and culture are tools used in diagnosis. Recently, DNA sequencing has also been used successfully. Though both infections manifest with similar clinical findings, Actinomycetoma has a rapid course and can lead to amputation or death secondary to systemic spread. However, actinomycetomas are more responsive to antibiotics, whereas eumycetomas require surgical excision in addition to antifungals. Complications include secondary bacterial infections that can progress to full-blown bacteremia or septicemia, resulting in death. With extremely disfiguring sequelae, following the breakdown of the nodules and formation of discharging sinuses, it poses a therapeutic challenge.

  7. 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.

  8. 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.

  9. 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.

  10. 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...

  11. 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.

  12. Robust Foot Clearance Estimation Based on the Integration of Foot-Mounted IMU Acceleration Data.

    Science.gov (United States)

    Benoussaad, Mourad; Sijobert, Benoît; Mombaur, Katja; Coste, Christine Azevedo

    2015-12-23

    This paper introduces a method for the robust estimation of foot clearance during walking, using a single inertial measurement unit (IMU) placed on the subject's foot. The proposed solution is based on double integration and drift cancellation of foot acceleration signals. The method is insensitive to misalignment of IMU axes with respect to foot axes. Details are provided regarding calibration and signal processing procedures. Experimental validation was performed on 10 healthy subjects under three walking conditions: normal, fast and with obstacles. Foot clearance estimation results were compared to measurements from an optical motion capture system. The mean error between them is significantly less than 15 % under the various walking conditions.

  13. Antimicrobial Susceptibility Pattern in Diabetic Foot Ulcer: A Pilot Study

    African Journals Online (AJOL)

    Globally, diabetic foot ulcers are one of the major public ... Background: Diabetic foot infections (DFIs) are major public health problems and knowledge ... Keywords: Antibiotic resistance, Antimicrobial susceptibility, Diabetic foot infection,.

  14. Diabetic Foot and Risk: How to Prevent Losing Your Leg

    Science.gov (United States)

    ... Site Content AOFAS / FootCareMD / Conditions / Diabetic Foot The Diabetic Foot and Risk: How to Prevent Losing Your ... Page Content Don't deny you are a diabetic Anyone who has ever had an elevated blood ...

  15. 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.

  16. Physical restraint use among nursing home residents: A comparison of two data collection methods

    Directory of Open Access Journals (Sweden)

    Voyer Philippe

    2004-10-01

    Full Text Available Abstract Background In view of the issues surrounding physical restraint use, it is important to have a method of measurement as valid and reliable as possible. We determined the sensitivity and specificity of physical restraint use a reported by nursing staff and b reviewed from medical and nursing records in nursing home settings, by comparing these methods with direct observation. Methods We sampled eight care units in skilled nursing homes, seven care units in nursing homes and one long-term care unit in a hospital, from eight facilities which included 28 nurses and 377 residents. Physical restraint use was assessed the day following three periods of direct observation by two different means: interview with one or several members of the regular nursing staff, and review of medical and nursing records. Sensitivity and specificity values were calculated according to 2-by-2 contingency tables. Differences between the methods were assessed using the phi coefficient. Other information collected included: demographic characteristics, disruptive behaviors, body alignment problems, cognitive and functional skills. Results Compared to direct observation (gold standard, reported restraint use by nursing staff yielded a sensitivity of 87.4% at a specificity of 93.7% (phi = 0.84. When data was reviewed from subjects' medical and nursing records, sensitivity was reduced to 74.8%, and specificity to 86.3% (phi = 0.54. Justifications for restraint use including risk for falls, agitation, body alignment problems and aggressiveness were associated with the use of physical restraints. Conclusions The interview of nursing staff and the review of medical and nursing records are both valid and reliable techniques for measuring physical restraint use among nursing home residents. Higher sensitivity and specificity values were achieved when nursing staff was interviewed as compared to reviewing medical records. This study suggests that the interview of nursing

  17. Physical restraint use among nursing home residents: A comparison of two data collection methods

    Science.gov (United States)

    Laurin, Danielle; Voyer, Philippe; Verreault, René; Durand, Pierre J

    2004-01-01

    Background In view of the issues surrounding physical restraint use, it is important to have a method of measurement as valid and reliable as possible. We determined the sensitivity and specificity of physical restraint use a) reported by nursing staff and b) reviewed from medical and nursing records in nursing home settings, by comparing these methods with direct observation. Methods We sampled eight care units in skilled nursing homes, seven care units in nursing homes and one long-term care unit in a hospital, from eight facilities which included 28 nurses and 377 residents. Physical restraint use was assessed the day following three periods of direct observation by two different means: interview with one or several members of the regular nursing staff, and review of medical and nursing records. Sensitivity and specificity values were calculated according to 2-by-2 contingency tables. Differences between the methods were assessed using the phi coefficient. Other information collected included: demographic characteristics, disruptive behaviors, body alignment problems, cognitive and functional skills. Results Compared to direct observation (gold standard), reported restraint use by nursing staff yielded a sensitivity of 87.4% at a specificity of 93.7% (phi = 0.84). When data was reviewed from subjects' medical and nursing records, sensitivity was reduced to 74.8%, and specificity to 86.3% (phi = 0.54). Justifications for restraint use including risk for falls, agitation, body alignment problems and aggressiveness were associated with the use of physical restraints. Conclusions The interview of nursing staff and the review of medical and nursing records are both valid and reliable techniques for measuring physical restraint use among nursing home residents. Higher sensitivity and specificity values were achieved when nursing staff was interviewed as compared to reviewing medical records. This study suggests that the interview of nursing staff is a more reliable

  18. Urinary excretion of cortisol from rhesus monkeys (Macaca mulatta) habituated to restraint

    Science.gov (United States)

    Wade, C. E.; Ortiz, R. M.

    1997-01-01

    Use of monkeys in research has often required that they be restrained in a chair. However, chair restraint can elicit an initial neuroendocrine stress response. Also, inactivity associated with restraint can induce muscular atrophy. We proposed that prior habituation of monkeys to chair restraint would attenuate these neuroendocrine responses without causing substantial muscle wasting. Four rhesus monkeys (Macaca mulatta) were trained and habituated to a restraint chair specifically designed for spaceflight. During the study, monkeys were placed in metabolic cages for 7 days (prerestraint, Phase I), placed in a chair restraint for 18 days (Phase II), and then returned to their metabolic cages for 5 days (postrestraint, Phase III). Urine was collected between 0700-1100 daily, and measurements of cortisol, creatinine, and electrolyte concentrations were adjusted for hourly excretion rates. Body weights of the monkeys did not change between start of the prerestraint and postrestraint phases (10.3 +/- 0.8 vs. 10.3 +/- 0.9 kg, respectively). During the 3 phases, mean excretion rate of cortisol did not change (24.1 +/- 10.3, 26.7 +/- 7.7, and 19.3 +/- 5.8 microg/h, respectively). Mean excretion rate of creatinine (37.3 +/- 7.5, 37.5 +/- 12.2, and 36.9 +/- 17.1 mg/h, respectively), Na+ (3.3 +/- 1.2, 3.2 +/- 1.2, 2.2 +/- 1.8 mmol/h, respectively), and K+ (5.3 +/- 1.8, 5.4 +/- 1.6, and 4.3 +/- 2.8 mmol/h, respectively) were also not altered. Lack of an increase in excreted urinary cortisol suggested that prior habituation to chair restraint attenuated neuroendocrine responses reported previously. Also, the chair restraint method used appeared to allow adequate activity, because the monkeys did not have indices of muscle wasting.

  19. Restraint stress alters immune parameters and induces oxidative stress in the mouse uterus during embryo implantation.

    Science.gov (United States)

    Liu, Guanhui; Dong, Yulan; Wang, Zixu; Cao, Jing; Chen, Yaoxing

    2014-12-01

    The influence of stress on embryo implantation is not well understood. Prior studies have focused on later gestational stages and the long-term impact of stress on immune function. The objective of this study is to investigate the effects of restraint stress on the immune parameters and the oxidative states of the uterus during implantation. In this study, pregnant CD1 mice were subjected to restraint stress (4 h/d) on embryonic day 1 (E1) and sacrificed on E3, E5, and E7. Maternal plasma corticosterone (CORT) secretion and implantation sites in the uterus were examined. The uterine (excluding embryos) homogenate and uterine lymphocytes were collected to examine oxidative stress states and associated immune parameters. The results demonstrated that restraint stress increased maternal plasma CORT secretion and reduced the number of implantation sites by 15.3% on E5 and by 26.1% on E7. Moreover, restraint stress decreased the density of uterine natural killer (uNK) cells in the endometrium by 22.1-47.9% and increased the density of mast cells in the myometrium by 55.6-76.9%. Restraint stress remarkably decreased the CD3(+)CD4(+) T/CD3(+)CD8(+) T cell ratio (by 26.2-28.9%) and attenuated uterine lymphocyte proliferation and secretion of cytokines. In addition, restraint stress threatened the intracellular equilibrium between oxidants and antioxidants, resulting in decreased glutathione peroxidase (GSH-PX) (32.2% and 45.7%), superoxide dismutase (SOD) (15.5% and 26.1%), and total antioxidant capacity (T-AOC) (18.4% and 18.2%) activities and increased malondialdehyde (MDA) (34.4% and 43.0%) contents on E5 and E7. In conclusion, these findings demonstrate that restraint stress causes abnormal implantation and negatively impacts immune parameters in association with oxidative stress in mice.

  20. The use of chemical restraints reduces agitation in patients transported by emergency medical services.

    Science.gov (United States)

    Weiss, Steve; Peterson, Kari; Cheney, Paul; Froman, Phil; Ernst, Amy; Campbell, Micha

    2012-11-01

    Agitated patients are the primary source of injury to patients and providers during ambulance transport. Our primary hypothesis was that the addition of a chemical restraint agent (midazolam) to a restraint protocol would reduce agitation to a greater extent than a restraint protocol with physical restraint alone. The local emergency medical services restraint protocol (RP) was implemented on October 1, 2006. It included a form for data collection about each restrained patient. On April 1, 2007, chemical restraint (CR) using midazolam in addition to physical restraints was made available through the RP, and paramedics were educated in its use. Transported patients were divided into pre-CR and post-CR. The post-CR group was split into those who received and those who did not receive midazolam. Agitation was measured on a validated agitation behavior scale with a parametric (Rasch) adjustment. There were 96 patients in the pre-CR group and 522 patients in the post-CR group. Forty-three percent of the pre-CR group and 49% of the post-CR group had a decrease in agitation during transport (NS). Of the 522 in the post-CR group, 110 were physically restrained and given midazolam (21%) and 412 were physically restrained without midazolam (79%). There was a significantly greater decrease in agitation scores (-17 ± 21 vs. -7 ± 17) in the subjects receiving midazolam compared to those who did not. If available, CR is used in about 20% of restrained patients. When CR is used, there is a decrease in the subject's agitation. Copyright © 2012 Elsevier Inc. All rights reserved.

  1. Efficient foot motor control by Neymar's brain.

    Science.gov (United States)

    Naito, Eiichi; Hirose, Satoshi

    2014-01-01

    How very long-term (over many years) motor skill training shapes internal motor representation remains poorly understood. We provide valuable evidence that the football brain of Neymar da Silva Santos Júnior (the Brasilian footballer) recruits very limited neural resources in the motor-cortical foot regions during foot movements. We scanned his brain activity with a 3-tesla functional magnetic resonance imaging (fMRI) while he rotated his right ankle at 1 Hz. We also scanned brain activity when three other age-controlled professional footballers, two top-athlete swimmers and one amateur footballer performed the identical task. A comparison was made between Neymar's brain activity with that obtained from the others. We found activations in the left medial-wall foot motor regions during the foot movements consistently across all participants. However, the size and intensity of medial-wall activity was smaller in the four professional footballers than in the three other participants, despite no difference in amount of foot movement. Surprisingly, the reduced recruitment of medial-wall foot motor regions became apparent in Neymar. His medial-wall activity was smallest among all participants with absolutely no difference in amount of foot movement. Neymar may efficiently control given foot movements probably by largely conserving motor-cortical neural resources. We discuss this possibility in terms of over-years motor skill training effect, use-dependent plasticity, and efficient motor control.

  2. [The "diabetic foot" syndrome. An overview].

    Science.gov (United States)

    Chantelau, E

    1999-01-01

    Amputation has been used most frequently to treat the diabetic foot syndrome, occlusive microangiopathy being suspected as the underlying cause. This paradigm is obsolete: most diabetic foot lesions are due to traumatic painless (neuropathic) infections. Evidence is presented for alternative treatment strategies to effectively reduce exorbitant amputation rates in diabetic patients.

  3. Louisiana farm discussion: 8 foot row spacing

    Science.gov (United States)

    This year several tests in growers’ fields were used to compare traditional 6-foot row spacing to 8-foot row spacing. Cane is double-drilled in the wider row spacing. The wider row spacing would accommodate John Deere 3522 harvester. Field data indicate the sugarcane yields are very comparable in 8-...

  4. Cosmetic Foot Surgery: Fashion's Pandora's Box

    Science.gov (United States)

    ... Fashion’s Pandora’s Box? A A A | Print | Share Cosmetic Foot Surgery: Fashion’s Pandora’s Box? Foot and ankle ... extreme and imprudent as it may sound, the cosmetic surgery craze is not just for faces anymore— ...

  5. Attitudes of nurses towards the use of physical restraints in geriatric care: a systematic review of qualitative and quantitative studies.

    Science.gov (United States)

    Möhler, Ralph; Meyer, Gabriele

    2014-02-01

    To examine nurses' attitudes towards the use of physical restraints in geriatric care. Systematic review and synthesis of qualitative and quantitative studies. The following databases were searched: Medline, CINAHL, EMBASE, Psyndex, PsychInfo, Social SciSearch, SciSearch, Forum Qualitative Social Research (1/1990 to 8/2013). We performed backward and forward citation tracking to all of the included studies. We included in the present review all qualitative and quantitative studies in English and German that investigated nurses' attitudes towards the use of physical restraints in geriatric care. Two independent reviewers selected the studies for inclusion and assessed the study quality. We performed a thematic synthesis for the qualitative studies and a content analysis of the questionnaires' items as well as a narrative synthesis for the quantitative surveys. We included 31 publications in the review: 20 quantitative surveys, 10 qualitative and 1 mixed-method study. In the qualitative studies, nurses' attitudes towards the use of physical restraints in geriatric care were predominately characterised by negative feelings towards the use of restraints; however, the nurses also described a perceived need for using restraints in clinical practice. This discrepancy led to moral conflicts, and nurses described several strategies for coping with these conflicts when restraints were used. When nurses were in doubt regarding the use of restraints, they decided predominantly in favour of using restraints. The results of the quantitative surveys were inconsistent regarding nurses' feelings towards the use of restraints in geriatric care. Prevention of falls was identified as a primary reason for using restraints. However, the items of the questionnaires focussed primarily on the reasons for the use of restraints rather than on the attitudes of nurses. Despite the lack of evidence regarding the benefits of restraints and the evidence on the adverse effects, nurses often

  6. The role of foot morphology on foot function in diabetic subjects with or without neuropathy.

    Science.gov (United States)

    Guiotto, Annamaria; Sawacha, Zimi; Guarneri, Gabriella; Cristoferi, Giuseppe; Avogaro, Angelo; Cobelli, Claudio

    2013-04-01

    The aim of this study was to investigate the role of foot morphology, related with respect to diabetes and peripheral neuropathy in altering foot kinematics and plantar pressure during gait. Healthy and diabetic subjects with or without neuropathy with different foot types were analyzed. Three dimensional multisegment foot kinematics and plantar pressures were assessed on 120 feet: 40 feet (24 cavus, 20 with valgus heel and 11 with hallux valgus) in the control group, 80 feet in the diabetic (25 cavus 13 with valgus heel and 13 with hallux valgus) and the neuropathic groups (28 cavus, 24 with valgus heel and 18 with hallux valgus). Subjects were classified according to their foot morphology allowing further comparisons among the subgroups with the same foot morphology. When comparing neuropathic subjects with cavus foot, valgus heel with controls with the same foot morphology, important differences were noticed: increased dorsiflexion and peak plantar pressure on the forefoot (Pfoot morphology in altering both kinematics and plantar pressure in diabetic subjects, diabetes appeared to further contribute in altering foot biomechanics. Surprisingly, all the diabetic subjects with normal foot arch or with valgus hallux were no more likely to display significant differences in biomechanics parameters than controls. This data could be considered a valuable support for future research on diabetic foot function, and in planning preventive interventions.

  7. An overview of the Charcot foot pathophysiology.

    Science.gov (United States)

    Kaynak, Gökhan; Birsel, Olgar; Güven, Mehmet Fatih; Oğüt, Tahir

    2013-01-01

    Charcot arthropathy of the foot is a rare but devastating complication of diabetes that remains to be a challenging issue for the foot and ankle surgeons. Charcot foot fails to be an obvious diagnostic option that comes to mind, even in a pathognomonic clinical appearance. The rarity of the disorder, more common pathologies that mimic the condition, and the self-limiting prognosis deviate the clinician from the right diagnosis. The clinical challenges in the diagnosis of Charcot foot require in-depth investigations of its enigmatic nature to establish useful guidelines. Yet, this goal seems to be beyond reach, without a holistic view of the immense literature concerning the pathophysiology of the disorder. The primary objective of this article is to put together and review the recent advancements about the etiology and intrinsic mechanisms of diabetic Charcot foot.

  8. An overview of the Charcot foot pathophysiology

    Directory of Open Access Journals (Sweden)

    Gökhan Kaynak

    2013-08-01

    Full Text Available Charcot arthropathy of the foot is a rare but devastating complication of diabetes that remains to be a challenging issue for the foot and ankle surgeons. Charcot foot fails to be an obvious diagnostic option that comes to mind, even in a pathognomonic clinical appearance. The rarity of the disorder, more common pathologies that mimic the condition, and the self-limiting prognosis deviate the clinician from the right diagnosis. The clinical challenges in the diagnosis of Charcot foot require in-depth investigations of its enigmatic nature to establish useful guidelines. Yet, this goal seems to be beyond reach, without a holistic view of the immense literature concerning the pathophysiology of the disorder. The primary objective of this article is to put together and review the recent advancements about the etiology and intrinsic mechanisms of diabetic Charcot foot.

  9. Restraint Stress Intensifies Interstitial K+ Accumulation during Severe Hypoxia

    Science.gov (United States)

    Schnell, Christian; Janc, Oliwia A.; Kempkes, Belinda; Callis, Carolina Araya; Flügge, Gabriele; Hülsmann, Swen; Müller, Michael

    2012-01-01

    Chronic stress affects neuronal networks by inducing dendritic retraction, modifying neuronal excitability and plasticity, and modulating glial cells. To elucidate the functional consequences of chronic stress for the hippocampal network, we submitted adult rats to daily restraint stress for 3 weeks (6 h/day). In acute hippocampal tissue slices of stressed rats, basal synaptic function and short-term plasticity at Schaffer collateral/CA1 neuron synapses were unchanged while long-term potentiation was markedly impaired. The spatiotemporal propagation pattern of hypoxia-induced spreading depression episodes was indistinguishable among control and stress slices. However, the duration of the extracellular direct current potential shift was shortened after stress. Moreover, K+ fluxes early during hypoxia were more intense, and the postsynaptic recoveries of interstitial K+ levels and synaptic function were slower. Morphometric analysis of immunohistochemically stained sections suggested hippocampal shrinkage in stressed rats, and the number of cells that are immunoreactive for glial fibrillary acidic protein was increased in the CA1 subfield indicating activation of astrocytes. Western blots showed a marked downregulation of the inwardly rectifying K+ channel Kir4.1 in stressed rats. Yet, resting membrane potentials, input resistance, and K+-induced inward currents in CA1 astrocytes were indistinguishable from controls. These data indicate an intensified interstitial K+ accumulation during hypoxia in the hippocampus of chronically stressed rats which seems to arise from a reduced interstitial volume fraction rather than impaired glial K+ buffering. One may speculate that chronic stress aggravates hypoxia-induced pathophysiological processes in the hippocampal network and that this has implications for the ischemic brain. PMID:22470344

  10. Women, sex and marriage. Restraint as a feminine strategy.

    Science.gov (United States)

    Kishwar, M

    1997-01-01

    The expression of sexuality varies in different cultures, and most societies attempt to control sexuality through the institution of marriage. In the West, the availability of cheap, effective contraceptives separated sex from reproduction and promoted the sexual liberation of women. Today, while divorce is common, sexually liberated people nevertheless engage in a form of serial monogamy. Sexual liberation in the West causes women to be exploited by men and creates instability in nuclear families. In India, feminism is tempered by a belief that familial rights have precedence over individual rights. India women practice sexual self-denial after being widowed to protect their children and to gain power and respect in the community. The power of chastity was illustrated by Mahatma Gandhi who marshalled his spiritual forces to fight for independence. The stories of many individual women illustrate how they attain status and prestige through chastity. Other women maintain absolute marital faithfulness as a marital strategy to control wayward husbands. These women deemphasize their roles as wives and emphasize their roles as mothers. The children of such women often recognize their sacrifices and become their strongest allies. On the other hand, examples of women who have chosen sexual freedom show that such a choice places them at the mercy of men, makes them social outcasts, and causes other women to distrust them as competitors for their husbands. In patriarchal societies, women can not win if they try to mimic men's capacity for irresponsible sex. Sexual freedom can only work for women in matrilineal communities that shun marriage in favor of strong ties within a woman's natal family. Indian women rooted in the extended family enjoy the resilience and flexibility attendant upon playing a larger role than simply pleasing men. Opting for sexual restraint can be an effective though costly strategy to achieve the sympathy and support of an extended family when a man is

  11. Body dissatisfaction and dietary restraint influence binge eating behavior.

    Science.gov (United States)

    Andrés, Ana; Saldaña, Carmina

    2014-11-01

    As binge eating is a common behavior throughout the general population, we hypothesized that body dissatisfaction would produce binge eating via its prediction of dieting. Six hundred eight individuals were nonrandomly recruited from the community. The mean age and body mass index of participants were 34.76 years (SD, 14.41) and 27.82 kg/m(2) (SD, 9.54), respectively. Participants were asked to complete several self-report questionnaires, which included measures of dieting status, binge eating behavior, body dissatisfaction, overvaluation of weight and shape, and self-esteem. The results showed that dieting was a common behavior; 38.1% of participants reported dieting during the past year. Binge eating during the previous 6 months was reported by 9.9% of the sample and was associated with a higher body mass index as well as more frequent dieting. A model including dieting status, overvaluation of weight and shape, shape satisfaction, and self-esteem showed the best fit for the prediction of binge eating behavior. Moreover, those who dieted and overvalued their weight and shape were 2.01 and 2.31 times more likely, respectively, to binge eat. Structural equation modeling revealed that body dissatisfaction caused dietary restraint, thus triggering binge eating. Both dieting and overvaluation of weight and shape are important risk factors for the development of binge eating disorders. Dieting and binge eating are common behaviors that represent a risk for the development of both excess weight and eating disorders. The structural model proposed in this study could be beneficial in understanding this causal relationship.

  12. The foot core system: a new paradigm for understanding intrinsic foot muscle function.

    Science.gov (United States)

    McKeon, Patrick O; Hertel, Jay; Bramble, Dennis; Davis, Irene

    2015-03-01

    The foot is a complex structure with many articulations and multiple degrees of freedom that play an important role in static posture and dynamic activities. The evolutionary development of the arch of the foot was coincident with the greater demands placed on the foot as humans began to run. The movement and stability of the arch is controlled by intrinsic and extrinsic muscles. However, the intrinsic muscles are largely ignored by clinicians and researchers. As such, these muscles are seldom addressed in rehabilitation programmes. Interventions for foot-related problems are more often directed at externally supporting the foot rather than training these muscles to function as they are designed. In this paper, we propose a novel paradigm for understanding the function of the foot. We begin with an overview of the evolution of the human foot with a focus on the development of the arch. This is followed by a description of the foot intrinsic muscles and their relationship to the extrinsic muscles. We draw the parallels between the small muscles of the trunk region that make up the lumbopelvic core and the intrinsic foot muscles, introducing the concept of the foot core. We then integrate the concept of the foot core into the assessment and treatment of the foot. Finally, we call for an increased awareness of the importance of the foot core stability to normal foot and lower extremity function. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  13. 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

  14. Motivating drivers to correctly adjust head restraints: assessing effectiveness of three different interventions.

    Science.gov (United States)

    Fockler, S K; Vavrik, J; Kristiansen, L

    1998-11-01

    Three types of driver educational strategies were tested to determine the most effective approach for motivating drivers to adjust their head restraints to the correct vertical position: (1) a human interactive personal contact with a member of an ICBC-trained head restraint adjustment team, (2) a passive video presentation of the consequences of correct and incorrect head restraint adjustment, and (3) an interactive three-dimensional kinetic model showing the consequences of correct and incorrect head restraint adjustment. An experimental pretest-posttest control group design was used. A different educational treatment was used in each of three lanes of a vehicle emissions testing facility, with a fourth lane with no intervention serving as a control group. Observational and self-reported data were obtained from a total of 1,974 vehicles entering and exiting the facility. The human intervention led to significantly more drivers actually adjusting their head restraints immediately after the intervention than the passive video or interactive kinetic model approaches, which were both no different from the control group. The human intervention was recommended as the most effective and was implemented successfully on a limited basis during 3 months of 1995 and again during 3 months of 1996.

  15. [Physical restraint of patients: historical notes relating to the nineteenth and twentieth century].

    Science.gov (United States)

    Fariña-López, Emilio; Estévez-Guerra, Gabriel J

    2011-03-01

    Physical restraint has been historically considered a necessary procedure to control the behaviour of the mentally ill. In the late eighteenth century moral treatment would pave the way for new initiatives against restraint, such as those instituted by British psychiatrists. They stressed the importance of training and supervision, as well as a minimum staff ratio, as being determining factors in reducing the use of restraint. This philosophy of treatment, despite its benefits, was introduced later and to a lesser extent in the rest of Europe, although, in other countries care was also made more humane through new therapeutic procedures. By contrast, in the United States most psychiatrists disagreed with those who advocated non-restraint, and continued using controversial methods to control the behaviour of patients. In Spain many difficulties hindered the improvement of conditions in institutions, many of which were in a sorry state. The initiatives of a few professionals and some cautious legal advances tried to alleviate the harshness of the treatment methods used. In the early twentieth century professional manuals were already available, which included the care to be given during the application of physical restraints. However it was not until the 1950, when the emergence of new psychotropic drugs and the distribution of important guidelines on the protection of the rights of patients that the widespread use of this procedure would be successfully reduced.

  16. Prevalence, risk factors, and outcomes associated with physical restraint use in mechanically ventilated adults.

    Science.gov (United States)

    Rose, Louise; Burry, Lisa; Mallick, Ranjeeta; Luk, Elena; Cook, Deborah; Fergusson, Dean; Dodek, Peter; Burns, Karen; Granton, John; Ferguson, Niall; Devlin, John W; Steinberg, Marilyn; Keenan, Sean; Reynolds, Stephen; Tanios, Maged; Fowler, Robert A; Jacka, Michael; Olafson, Kendiss; Skrobik, Yoanna; Mehta, Sangeeta

    2016-02-01

    The purpose was to describe characteristics and outcomes of restrained and nonrestrained patients enrolled in a randomized trial of protocolized sedation compared with protocolized sedation plus daily sedation interruption and to identify patient and treatment factors associated with physical restraint. This was a post hoc secondary analysis using Cox proportional hazards modeling adjusted for center- and time-varying covariates to evaluate predictors of restraint use. A total of 328 (76%) of 430 patients were restrained for a median of 4 days. Restrained patients received higher daily doses of benzodiazepines (105 vs 41 mg midazolam equivalent, P < .0001) and opioids (1524 vs 919 μg fentanyl equivalents, P < .0001), more days of infusions (benzodiazepines 6 vs 4, P < .0001; opioids 7 vs 5, P = .02), and more daily benzodiazepine boluses (0.2 vs 0.1, P < .0001). More restrained patients received haloperidol (23% vs 12%, P = .02) and atypical antipsychotics (17% vs 4%, P = .003). More restrained patients experienced unintentional device removal (26% vs 3%, P < .001) and required reintubation (8% vs 1%, P = .01). In the multivariable analysis, alcohol use was associated with decreased risk of restraint (hazard ratio, 0.22; 95% confidence interval, 0.08-0.58). Physical restraint was common in mechanically ventilated adults managed with a sedation protocol. Restrained patients received more opioids and benzodiazepines. Except for alcohol use, patient characteristics and treatment factors did not predict restraint use. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. 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.

  18. Nursing staff views of barriers to physical restraint reduction in nursing homes.

    Science.gov (United States)

    Kong, Eun-Hi; Evans, Lois K

    2012-12-01

    There are few studies globally regarding the barriers to restraint-reduction. The purpose of this study was to describe the views of nursing staff (both nurses and geriatric care assistants) regarding the barriers to reducing physical restraint use in Korean nursing homes. Forty registered nurse and geriatric care assistant informants participated in the first round of interviews and 16 of them participated in second confirmatory interviews. All interviews were conducted on site, one-on-one and face-to-face, using semi-structured interview protocols. Qualitative descriptive method was used and qualitative content analysis was employed. Six themes were identified: (a) being too busy, (b) lack of resources, (c) beliefs and concerns, (d) lack of education, (e) differences and inconsistencies, and (f) relationship issues. 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. Copyright © 2012. Published by Elsevier B.V.

  19. The use of physical restraints in elder care in relation to fall risk.

    Science.gov (United States)

    Karlsson, S; Nyberg, L; Sandman, P O

    1997-01-01

    Physical restraints are a frequently used but disputed method to prevent falls. The aim of the present study was to investigate how the use of restraints in institutional elder care relates to previous falls and to the estimated fall risk of the individual patient. A total of 1142 patients, mean age 82 years, were included in the study. A questionnaire, the Multi-Dimensional Dementia Assessment Scale (MDDAS), was used to measure motor function, vision, hearing, ADL performance, behavioral symptoms, psychiatric symptoms, cognitive impairment and use of medication. Questions concerning the use of physical restraints and known previous falls were added to the instrument. Based on data from the questionnaire (MDDAS), a score on the Downton Fall Risk Index was calculated for each patient. All in all, 248 (22%) of the patients had been subject to restraints and for 155 of them (14%) such measures had been taken to prevent falls. Only weak connections were found between the restraining of patients to prevent falls and the prevalence of known previous falls during hospital stay (phi = 0.05), and estimated fall risk (phi = 0.07). The results indicate that the use of physical restraints is poorly connected with the estimated fall risk. Therefore, this study may point to a possible overuse of these measures.

  20. Women with high scores for cognitive dietary restraint choose foods lower in fat and energy.

    Science.gov (United States)

    Rideout, Candice A; McLean, Judy A; Barr, Susan I

    2004-07-01

    Women with high dietary restraint typically report restricting energy intake and using reduced-kilocalorie foods in an effort to achieve or maintain a certain body weight. However, previous studies of food choices associated with dietary restraint have been limited by the self-report of participants' food selections. We provided all foods consumed during a free-living 24-hour period to 62 normal-weight women with high (n=33) or low (n=29) dietary restraint, and observed choices from among similar foods varying in fat, fiber, and energy content. Women with high dietary restraint consumed less energy and chose reduced-kilocalorie and reduced-fat foods more frequently than unrestrained eaters. Group differences in choices of milk, cream cheese, mayonnaise, salad dressing, and soda were noted. Dietitians may consider frequent use of reduced-kilocalorie and reduced-fat foods a potential indicator of high dietary restraint, which may have health consequences. Accordingly, further exploration of clients' tendency to restrict dietary intake may be warranted.

  1. Success importance and urge magnitude as determinants of cardiovascular response to a behavioral restraint challenge.

    Science.gov (United States)

    Agtarap, Stephanie D; Wright, Rex A; Mlynski, Christopher; Hammad, Rawan; Blackledge, Sabrina

    2016-04-01

    Decades of research have investigated a conceptual analysis concerned with determinants and cardiovascular correlates of effort in people confronted with performance challenges, that is, opportunities to alter some course of events by acting. One suggestion is that effort and associated cardiovascular responses should be determined jointly by the difficulty of meeting a challenge and the importance of doing so. The present experiment tested this in a context involving behavioral restraint, that is, effortful resistance against a behavioral impulse or urge. Participants were presented a mildly evocative violent film clip (restraint difficulty low) or a strongly evocative violent film clip (restraint difficulty high) with instructions to refrain from showing any facial response. Success was made more or less important through coordinated manipulations of outcome expectancy, ego-involvement and social evaluation. As expected, SBP responses assessed during the work period were proportional to clip evocativeness - i.e., the difficulty of the restraint challenge - when importance was high, but low regardless of clip evocativeness when importance was low. Findings conceptually replicate previous cardiovascular results and support extension of the guiding analysis to the behavioral restraint realm.

  2. Chemical restraint in routine clinical practice: a report from a general hospital psychiatric ward in Greece

    Directory of Open Access Journals (Sweden)

    Papamichael Georgios

    2011-02-01

    Full Text Available Abstract Background There is a dearth of studies regarding chemical restraint in routine clinical psychiatric practice. There may be wide variations between different settings and countries. Methods A retrospective study on chemical restraint was performed in the 11-bed psychiatric ward of the General Hospital of Arta, in northwestern Greece. All admissions over a 2-year-period (from March 2008 to March 2010 were examined. Results Chemical restraint was applied in 33 cases (10.5% of total admissions. From a total of 82 injections, 22 involved a benzodiazepine and/or levomepromazine, whereas 60 injections involved an antipsychotic agent, almost exclusively haloperidol (96.7% of cases, usually in combination with a benzodiazepine (61.7% of cases. In 36.4% of cases the patient was further subjected to restraint or seclusion. Conclusions In our unit, clinicians prefer the combined antipsychotic/benzodiazepine regimen for the management of patients' acute agitation and violent behaviour. Conventional antipsychotics are administrated almost exclusively and in a significant proportion of cases further coercive measures are applied. Studies on the practice of chemical restraint should be regularly performed in clinical settings.

  3. Depressed affect and dietary restraint in adolescent boys' and girls' eating in the absence of hunger.

    Science.gov (United States)

    Kelly, Nichole R; Shomaker, Lauren B; Pickworth, Courtney K; Grygorenko, Mariya V; Radin, Rachel M; Vannucci, Anna; Shank, Lisa M; Brady, Sheila M; Courville, Amber B; Tanofsky-Kraff, Marian; Yanovski, Jack A

    2015-08-01

    Data suggest that depressed affect and dietary restraint are related to disinhibited eating patterns in children and adults. Yet, experimental research has not determined to what extent depressed affect acutely affects eating in the absence of physiological hunger (EAH) in adolescents. In the current between-subjects experimental study, we measured EAH in 182 adolescent (13-17 y) girls (65%) and boys as ad libitum palatable snack food intake after youth ate to satiety from a buffet meal. Just prior to EAH, participants were randomly assigned to view either a sad or neutral film clip. Dietary restraint was measured with the Eating Disorder Examination. Adolescents who viewed the sad film clip reported small but significant increases in state depressed affect relative to adolescents who viewed the neutral film clip (p < .001). Yet, there was no main effect of film condition on EAH (p = .26). Instead, dietary restraint predicted greater EAH among girls, but not boys (p < .001). These findings provide evidence that adolescent girls' propensity to report restrained eating is associated with their greater disinhibited eating in the laboratory. Additional experimental research, perhaps utilizing a more potent laboratory stressor and manipulating both affective state and dietary restraint, is required to elucidate how state affect may interact with dietary restraint to influence EAH during adolescence.

  4. Protein structure prediction using global optimization by basin-hopping with NMR shift restraints.

    Science.gov (United States)

    Hoffmann, Falk; Strodel, Birgit

    2013-01-14

    Computational methods that utilize chemical shifts to produce protein structures at atomic resolution have recently been introduced. In the current work, we exploit chemical shifts by combining the basin-hopping approach to global optimization with chemical shift restraints using a penalty function. For three peptides, we demonstrate that this approach allows us to find near-native structures from fully extended structures within 10,000 basin-hopping steps. The effect of adding chemical shift restraints is that the α and β secondary structure elements form within 1000 basin-hopping steps, after which the orientation of the secondary structure elements, which produces the tertiary contacts, is driven by the underlying protein force field. We further show that our chemical shift-restraint BH approach also works for incomplete chemical shift assignments, where the information from only one chemical shift type is considered. For the proper implementation of chemical shift restraints in the basin-hopping approach, we determined the optimal weight of the chemical shift penalty energy with respect to the CHARMM force field in conjunction with the FACTS solvation model employed in this study. In order to speed up the local energy minimization procedure, we developed a function, which continuously decreases the width of the chemical shift penalty function as the minimization progresses. We conclude that the basin-hopping approach with chemical shift restraints is a promising method for protein structure prediction.

  5. Involuntary medication, seclusion, and restraint in German psychiatric hospitals after the adoption of legislation in 2013

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    Erich eFlammer

    2015-10-01

    Full Text Available Background: Involuntary medication in psychiatric treatment of inpatients is highly controversial. While laws regulating involuntary medication have been changed in Germany, no data has been available to date on how often involuntary medication is actually applied. Recently, our hospital group introduced specific routine documentation of legal status and application of involuntary medication in the patients’ electronic records, which allows the assessment of the frequency of involuntary medication.Method: For the year 2014, we extracted aggregated data from the electronic database on age, sex, psychiatric diagnosis, legal status during admission, kind of coercive measure (mechanical restraint, seclusion, and involuntary medication applied, and the number and duration of seclusion and restraint episodes for seven study sites.Results: A total of 1,514 (9.6% of 15,832 admissions were involuntary. At least one coercive measure was applied in 976 (6.2% admissions. Seclusion was applied in 579 (3.7% admissions, mechanical restraint was applied in 529 (3.3% admissions, and involuntary medication was applied in 78 (0.5% admissions. Two-thirds of involuntary medications were applied in cases of emergency; the remainder was applied after a formal decision by a judge. In 55 (70.5% of the admissions with involuntary medication, at least one other coercive measure (seclusion, restraint, or both was applied as well.Conclusion: Involuntary medication is rarely applied and less frequent than seclusion or mechanical restraint, possibly as a consequence of recent legal restrictions.

  6. Footwear and foot care knowledge as risk factors for foot problems in Indian diabetics.

    Science.gov (United States)

    Chandalia, H B; Singh, D; Kapoor, V; Chandalia, S H; Lamba, P S

    2008-10-01

    We assessed 300 diabetic and 100 age- and sex-matched controls for correlating foot wear practices and foot care knowledge and the presence of foot complications. A structured questionnaire evaluated the knowledge about foot care, type of footwear used, education level, association of tobacco abuse, and any associated symptoms of foot disease. Clinical evaluation was done by inspection of feet for presence of any external deformities, assessment of sensory function (vibration perception threshold, VPT), vascular status (foot pulses and ankle brachial ratio) and presence of any infection.In the diabetes category, 44.7% patients had not received previous foot care education. 0.6% walked barefoot outdoors and 45% walked barefoot indoors. Fourteen (4.7%) patients gave history of foot ulceration in the past and comprised the high risk group; only 2 out of 14 had received foot care education, 6 gave history of tobacco abuse, 8 had symptoms of claudication, 9 had paresthesias, 2 walked barefoot indoors. Average duration of diabetes in the high-risk and low-risk diabetes group was 10.85 +/- 6.53 and 9.83 +/- 7.99 years, respectively. In the high- and low-risk diabetic groups, VPT was 19.57 +/- 11.26 and 15.20 +/- 10.21V (P practices were important risk factors for foot problems in diabetes.

  7. Foot roll-over evaluation based on 3D dynamic foot scan.

    Science.gov (United States)

    Samson, William; Van Hamme, Angèle; Sanchez, Stéphane; Chèze, Laurence; Van Sint Jan, Serge; Feipel, Véronique

    2014-01-01

    Foot roll-over is commonly analyzed to evaluate gait pathologies. The current study utilized a dynamic foot scanner (DFS) to analyze foot roll-over. The right feet of ten healthy subjects were assessed during gait trials with a DFS system integrated into a walkway. A foot sole picture was computed by vertically projecting points from the 3D foot shape which were lower than a threshold height of 15 mm. A 'height' value of these projected points was determined; corresponding to the initial vertical coordinates prior to projection. Similar to pedobarographic analysis, the foot sole picture was segmented into anatomical regions of interest (ROIs) to process mean height (average of height data by ROI) and projected surface (area of the projected foot sole by ROI). Results showed that these variables evolved differently to plantar pressure data previously reported in the literature, mainly due to the specificity of each physical quantity (millimeters vs Pascals). Compared to plantar pressure data arising from surface contact by the foot, the current method takes into account the whole plantar aspect of the foot, including the parts that do not make contact with the support surface. The current approach using height data could contribute to a better understanding of specific aspects of foot motion during walking, such as plantar arch height and the windlass mechanism. Results of this study show the underlying method is reliable. Further investigation is required to validate the DFS measurements within a clinical context, prior to implementation into clinical practice.

  8. Foot lengthening and shortening during gait: a parameter to investigate foot function?

    Science.gov (United States)

    Stolwijk, N M; Koenraadt, K L M; Louwerens, J W K; Grim, D; Duysens, J; Keijsers, N L W

    2014-02-01

    Based on the windlass mechanism theory of Hicks, the medial longitudinal arch (MLA) flattens during weight bearing. Simultaneously, foot lengthening is expected. However, changes in foot length during gait and the influence of walking speed has not been investigated yet. The foot length and MLA angle of 34 healthy subjects (18 males, 16 females) at 3 velocities (preferred, low (preferred -0.4 m/s) and fast (preferred +0.4 m/s) speed were investigated with a 3D motion analysis system (VICON(®)). The MLA angle was calculated as the angle between the second metatarsal head, the navicular tuberculum and the heel in the local sagittal plane. Foot length was calculated as the distance between the marker at the heel and the 2nd metatarsal head. A General Linear Model for repeated measures was used to indicate significant differences in MLA angle and foot length between different walking speeds. The foot lengthened during the weight acceptance phase of gait and shortened during propulsion. With increased walking speed, the foot elongated less after heel strike and shortened more during push off. The MLA angle and foot length curve were similar, except between 50% and 80% of the stance phase in which the MLA increases whereas the foot length showed a slight decrease. Foot length seems to represent the Hicks mechanism in the foot and the ability of the foot to bear weight. At higher speeds, the foot becomes relatively stiffer, presumably to act as a lever arm to provide extra propulsion. Copyright © 2013 Elsevier B.V. All rights reserved.

  9. Ethical considerations for evaluating the issue of physical restraint in psychiatry

    Directory of Open Access Journals (Sweden)

    Carlo Petrini

    2013-09-01

    Full Text Available This article examines some of the ethical issues associated with the use of physical restraint in psychiatry and neurology. It offers no specific answers to individual operational problems, but a methodological matrix is proposed as an aid to experts in the various settings in which decisions are taken. The subject is addressed mainly by considering two sources: reference documents published by eminent organisations, and the theoretical framework of ethical values (or principles. A number of analytical criteria arising from these sources are then identified and proposed. The proposed criteria can be applied in cases for which the legitimate use of restraint may be an option, bearing in mind that restraint is an extremely serious affront to human dignity and is widely held to be of no therapeutic value. Its abuse is illegitimate in both ethical and legal terms.

  10. Physical restraint and the protection of the human rights of immigration detainees in hospitals.

    Science.gov (United States)

    Pickles, Hilary; Norton, Emma; Ginn, Emma; Schleicher, Theresa

    2015-08-01

    Immigration detainees, like prisoners, are entitled to the same standard of healthcare as non-detained patients. When hospital attendance or admission is required, the priority for custodial staff (who for purposes of this article we refer to as 'escorts') is to prevent absconding. For that reason, they may wish to use physical restraints, such as handcuffs, and remain with the detainee at all times. This can be degrading for the patient and breach their human rights. Clinicians have professional obligations to all their patients and must object to any restraint methods that risk damaging the patient's right to confidentiality, treatment, health or the therapeutic relationship itself. The starting presumption is that restraints ought not to be used during treatment and only in the most exceptional cases ought escorts to be present during clinical examination or treatment. © Royal College of Physicians 2015. All rights reserved.

  11. Ethical considerations for evaluating the issue of physical restraint in psychiatry.

    Science.gov (United States)

    Petrini, Carlo

    2013-01-01

    This article examines some of the ethical issues associated with the use of physical restraint in psychiatry and neurology. It offers no specific answers to individual operational problems, but a methodological matrix is proposed as an aid to experts in the various settings in which decisions are taken. The subject is addressed mainly by considering two sources: reference documents published by eminent organisations, and the theoretical framework of ethical values (or principles). A number of analytical criteria arising from these sources are then identified and proposed. The proposed criteria can be applied in cases for which the legitimate use of restraint may be an option, bearing in mind that restraint is an extremely serious affront to human dignity and is widely held to be of no therapeutic value. Its abuse is illegitimate in both ethical and legal terms.

  12. 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.

  13. How Farm Animals React and Perceive Stressful Situations Such As Handling, Restraint, and Transport

    Directory of Open Access Journals (Sweden)

    Temple Grandin

    2015-12-01

    Full Text Available An animal that has been carefully acclimated to handling may willingly re-enter a restrainer. Another animal may have an intense agitated behavioral reaction or refuse to re-enter the handling facility. Physiological measures of stress such as cortisol may be very low in the animal that re-enters willingly and higher in animals that actively resist restraint. Carefully acclimating young animals to handling and restraint can help improve both productivity and welfare by reducing fear stress. Some of the topics covered in this review are: How an animal perceives handling and restraint, the detrimental effects of a sudden novel event, descriptions of temperament and aversion tests and the importance of good stockmanship.

  14. [Mechanical restraints in the elderly: technical proposals and recommendations for use in the social environment].

    Science.gov (United States)

    Rodríguez Delgado, Joan

    2013-01-01

    There is some confusion in the national gerontological literature in the use of terms that refer to mechanical restraints. There is a lack of dialogue as regards ethical conflicts that suggest their use, as well as a significant generalization of the claims against, and the absence of positive references despite its high prevalence as shown by some authors. This paper presents some technical proposals on the definition, the use of terms, and the use of mechanical restraints in the social environment, such as putting the ethical dialogue to arguments based on the prevalence, define them in terms of their intent, agree on a classification of the different restraint methods, identify the types and levels of risk, and intervene specifically in accordance with these proposals. Finally, recommendations are added with regards to risks, the decision process, prescription and the withdrawal process. Copyright © 2012 SEGG. Published by Elsevier Espana. All rights reserved.

  15. Surgical treatment of the Charcot foot.

    Science.gov (United States)

    Pinzur, Michael S

    2016-01-01

    With the increased number of diabetics worldwide and the increased incidence of morbid obesity in more prosperous cultures, there has become an increased awareness of Charcot arthropathy of the foot and ankle. Outcome studies would suggest that patients with deformity associated with Charcot Foot arthropathy have impaired health related quality of life. This awareness has led reconstructive-minded foot and ankle surgeons to develop surgical strategies to treat these acquired deformities. This article outlines the current clinical approach to this disabling medical condition.

  16. Predictors of physical restraint use in Canadian intensive care units.

    Science.gov (United States)

    Luk, Elena; Sneyers, Barbara; Rose, Louise; Perreault, Marc M; Williamson, David R; Mehta, Sangeeta; Cook, Deborah J; Lapinsky, Stephanie C; Burry, Lisa

    2014-03-24

    Physical restraint (PR) use in the intensive care unit (ICU) has been associated with higher rates of self-extubation and prolonged ICU length of stay. Our objectives were to describe patterns and predictors of PR use. We conducted a secondary analysis of a prospective observational study of analgosedation, antipsychotic, neuromuscular blocker, and PR practices in 51 Canadian ICUs. Data were collected prospectively for all mechanically ventilated adults admitted during a two-week period. We tested for patient, treatment, and hospital characteristics that were associated with PR use and number of days of use, using logistic and Poisson regression respectively. PR was used on 374 out of 711 (53%) patients, for a mean number of 4.1 (standard deviation (SD) 4.0) days. Treatment characteristics associated with PR were higher daily benzodiazepine dose (odds ratio (OR) 1.05, 95% confidence interval (CI) 1.00 to 1.11), higher daily opioid dose (OR 1.04, 95% CI 1.01 to 1.06), antipsychotic drugs (OR 3.09, 95% CI 1.74 to 5.48), agitation (Sedation-Agitation Scale (SAS) >4) (OR 3.73, 95% CI 1.50 to 9.29), and sedation administration method (continuous and bolus versus bolus only) (OR 3.09, 95% CI 1.74 to 5.48). Hospital characteristics associated with PR indicated patients were less likely to be restrained in ICUs from university-affiliated hospitals (OR 0.32, 95% CI 0.17 to 0.61). Mainly treatment characteristics were associated with more days of PR, including: higher daily benzodiazepine dose (incidence rate ratio (IRR) 1.07, 95% CI 1.01 to 1.13), daily sedation interruption (IRR 3.44, 95% CI 1.48 to 8.10), antipsychotic drugs (IRR 15.67, 95% CI 6.62 to 37.12), SAS <3 (IRR 2.62, 95% CI 1.08 to 6.35), and any adverse event including accidental device removal (IRR 8.27, 95% CI 2.07 to 33.08). Patient characteristics (age, gender, Acute Physiology and Chronic Health Evaluation II score, admission category, prior substance abuse, prior psychotropic medication, pre

  17. The effects of sex and hormonal status on restraint-stress-induced working memory impairment

    Directory of Open Access Journals (Sweden)

    Brennan Avis

    2006-03-01

    Full Text Available Abstract Background Restraint stress has been shown to elicit numerous effects on hippocampal function and neuronal morphology, as well as to induce dendritic remodeling in the prefrontal cortex (PFC. However, the effects of acute restraint stress on PFC cognitive function have not been investigated, despite substantial evidence that the PFC malfunctions in many stress-related disorders. Methods The present study examined the effects of restraint stress on PFC function in both male rats and cycling female rats in either the proestrus (high estrogen or estrus (low estrogen phase of the estrus cycle. Animals were restrained for 60 or 120 minutes and then tested on spatial delayed alternation, a PFC-mediated task. Performance after stress was compared to performance on a different day under no-stress conditions, and analyzed using analysis of variance (ANOVA. Results Sixty minutes of restraint impaired only females in proestrus, while 120 minutes of restraint produced significant impairments in all animals. Increases in task completion times did not affect performance. Conclusion These results demonstrate an interaction between hormonal status and cognitive response to stress in female rats, with high estrogen levels being associated with amplified sensitivity to stress. This effect has been previously observed after administration of a pharmacological stressor (the benzodiazepine inverse agonist FG7142, and results from both studies may be relevant to the increased prevalence of stress-related disorders, such as major depressive disorder, in cycling women. Overall, the results show that restraint stress has important effects on the cognitive functions of the PFC, and that hormonal influences in the PFC are an important area for future research.

  18. Effectiveness of a Multimodal Intervention Program for Restraint Prevention in an Acute Spanish Psychiatric Ward.

    Science.gov (United States)

    Guzman-Parra, Jose; Aguilera Serrano, Carlos; García-Sánchez, Juan A; Pino-Benítez, Isabel; Alba-Vallejo, Mercedes; Moreno-Küstner, Berta; Mayoral-Cleries, Fermin

    2016-05-01

    International recommendations have called to implement strategies to reduce the use of coercion in psychiatric settings. However, in Spain there is a lack of research about intervention programs to reduce mechanical restraint in acute psychiatric units. The aim of this study was to evaluate the effectiveness of a multimodal intervention program based on the principles of six core strategies to reduce the frequency of use of mechanical restraint in an acute psychiatric ward. The design was a retrospective analysis of the frequency and duration of episodes of mechanical restraint prior to the intervention program (2012) and during the intervention program (2013) in one acute psychiatric ward. The intervention was governed by four strategies: (1) leadership and organizational changes, (2) registration and monitoring of risk patients, (3) staff training, and (4) involving patients in the treatment program. There was a significant difference between the mean number of monthly episodes of mechanical restraint per 1,000 patient days, pre-intervention (18.54 ± 8.78) compared with postintervention (8.53 ± 7.00; p = .005). We found the probability that mechanical restraint would occur in a hospital admission decreased after performing the intervention (odds ratio = .587; confidence interval = 0.411-0.838; p = .003) after adjusting for confounding variables. The total percentage of restrained patients fell from 15.07% to 9.74%. The main implication of the study is to support the effectiveness of specific intervention programs based on different measures to reduce mechanical restraint and without contemplating all the strategies that are considered effective. © The Author(s) 2016.

  19. Knowledge, attitudes, and practices of Turkish intern nurses regarding physical restraints.

    Science.gov (United States)

    Karagozoglu, Serife; Ozden, Dilek; Yildiz, Fatma Tok

    2013-01-01

    This study was carried out to determine knowledge, attitudes, and practices of intern nurses who completed the nursing internship program on the use of physical restraints. This research was conducted using descriptive and cross-sectional research design. The study sample comprises 91 fourth-grade students who took an integrated curriculum and completed the nursing internship program. The data were collected with the Demographic Characteristics Questionnaire and the Levels of Knowledge, Attitudes and Practices of Staff Regarding Physical Restraints Questionnaire. For the assessment of the data, percentages, the arithmetic mean, and t test were used. The findings indicated that, of the intern nurses, 95.6% observed the use of physical restraints during their education, and 69.2% applied physical restraints. The mean knowledge, attitude, and practice scores of the nurses for physical restraint were 9.38 ± 1.19 (0-11 points), 34.70 ± 5.62 (12-48 points), and 37.95 ± 2.32 (14-42 points), respectively. Intern nurses' knowledge about how to use physical restraints was at a very good level; they displayed positive attitudes, and they used their knowledge and attitudes in their practices to a great extent. Although there are studies on the knowledge, attitudes, and practices of nurses working in the fields of elderly care, rehabilitation, and psychiatry in acute care units, there are no studies investigating intern nurses and other nursing students. However, intern nurses about to begin their careers should make accurate decisions regarding the use of physical restrains if they are to ensure patient safety and to fulfill this application effectively in their professional lives.

  20. Contextual influences on nurses' decision-making in cases of physical restraint.

    Science.gov (United States)

    de Casterlé, Bernadette Dierckx; Goethals, Sabine; Gastmans, Chris

    2015-09-01

    In order to fully understand nurses' ethical decision-making in cases of physical restraint in acute older people care, contextual influences on the process of decision-making should be clarified. What is the influence of context on nurses' decision-making process in cases of physical restraint, and what is the impact of context on the prioritizing of ethical values when making a decision on physical restraint? A qualitative descriptive study inspired by the Grounded Theory approach was carried out. In total, 21 in-depth interviews were carried out with nurses working on acute geriatric wards in Flanders, Belgium. The research protocol was approved by the Ethics Committee of the Faculty of Medicine, Leuven. Relationships with nursing colleagues and the patient's family form an inter-personal network. Nurses also point to the importance of the procedural-legal context as expressed in an institutional ethics policy and procedures, or through legal requirements concerning physical restraint. Furthermore, the architectural structure of a ward, the availability of materials and alternatives for restraint use can be decisive in nurses' decision-making. All interviewed nurses highlighted the unquestionable role of the practical context of care. Context can have a guiding, supportive, or decisive role in decision-making concerning the application of physical restraint. The discussion focuses on the role of the inter-personal network of nurses on the process of decision-making. An institutional ethics policy and a value-supportive care environment can support nurses in their challenge to take ethically sound decisions. © The Author(s) 2014.

  1. 5-foot Vertical Wind Tunnel

    Science.gov (United States)

    1932-01-01

    The researcher is sitting above the exit cone of the 5-foot Vertical Wind Tunnel and is examining the new 6-component spinning balance. This balance was developed between 1930 and 1933. It was an important advance in the technology of rotating or rolling balances. As M.J. Bamber and C.H. Zimmerman wrote in NACA TR 456: 'Data upon the aerodynamic characteristics of a spinning airplane may be obtained in several ways; namely, flight tests with full-scale airplanes, flight tests with balanced models, strip-method analysis of wind-tunnel force and moment tests, and wind-tunnel tests of rotating models.' Further, they note: 'Rolling-balance data have been of limited value because it has not been possible to measure all six force and moment components or to reproduce a true spinning condition. The spinning balance used in this investigation is a 6-component rotating balance from which it is possible to obtain wind-tunnel data for any of a wide range of possible spinning conditions.' Bamber and Zimmerman described the balance as follows: 'The spinning balance consists of a balance head that supports the model and contains the force-measuring units, a horizontal turntable supported by streamline struts in the center of the jet and, outside the tunnel, a direct-current driving motor, a liquid tachometer, an air compressor, a mercury manometer, a pair of indicating lamps, and the necessary controls. The balance head is mounted on the turntable and it may be set to give any radius of spin between 0 and 8 inches.' In an earlier report, NACA TR 387, Carl Wenzinger and Thomas Harris supply this description of the tunnel: 'The vertical open-throat wind tunnel of the National Advisory Committee for Aeronautics ... was built mainly for studying the spinning characteristics of airplane models, but may be used as well for the usual types of wind-tunnel tests. A special spinning balance is being developed to measure the desired forces and moments with the model simulating the actual

  2. Predictors of Physical Restraint Use in Hospitalized Veterans at End of Life: An Analysis of Data from the BEACON Trial.

    Science.gov (United States)

    Kvale, Elizabeth; Dionne-Odom, J Nicholas; Redden, David T; Bailey, F Amos; Bakitas, Marie; Goode, Patricia S; Williams, Beverly R; Haddock, Kathlyn Sue; Burgio, Kathryn L

    2015-06-01

    The use of physical restraints in dying patients may be a source of suffering and loss of dignity. Little is known about the prevalence or predictors for restraint use at end of life in the hospital setting. The objective was to determine the prevalence and predictors of physical restraint use at the time of death in hospitalized adults. Secondary analysis was performed on data from the "Best Practices for End-of-Life Care for Our Nation's Veterans" (BEACON) trial conducted between 2005 and 2011. Medical record data were abstracted from six Veterans Administration Medical Centers (VAMCs). Data on processes of care in the last seven days of life were abstracted from the medical records of 5476 who died in the six VAMCs. We prospectively identified potential risk factors for restraint use at the time of death from among the variables measured in the parent trial, including location of death, medications administered, nasogastric tube, intravenous (IV) fluids, family presence, and receipt of a palliative care consultation. Physical restraint use at time of death was documented in 890 decedents (16.3%). Restraint use varied by location of death, with patients in intensive settings being at higher risk. Restraint use was significantly more likely in patients with a nasogastric tube and those receiving IV fluids, benzodiazepines, or antipsychotics. This is the first study to document that one in six hospitalized veterans were restrained at the time of death and to identify predictors of restraint use. Further research is needed to identify intervention opportunities.

  3. Mindful Staff Can Reduce the Use of Physical Restraints when Providing Care to Individuals with Intellectual Disabilities

    Science.gov (United States)

    Singh, Nirbhay N.; Lancioni, Giulio E.; Winton, Alan S. W.; Singh, Ashvind N.; Adkins, Angela D.; Singh, Judy

    2009-01-01

    Background: The use of physical restraints has generated immense controversy in the delivery of services to individuals with intellectual disabilities. The current "zeitgeist" is that effective positive approaches obviate the need for using physical restraints. In a multiple baseline design, we sought to assess how training staff members in…

  4. The concept of restraints in nursing home practice: a mixed method study in nursing homes for people with dementia.

    NARCIS (Netherlands)

    Zwijsen, S.A.; Depla, M.F.I.A.; Niemeijer, A.R.; Francke, A.L.; Hertogh, C.M.P.M.

    2011-01-01

    Introduction: Although in most developed countries the use of restraints is regulated and restricted by law, the concept of restraint in nursing home care remains ambiguous. This study aims to explore how care professionals and family members of nursing home residents with dementia in the

  5. The nature and extent of the use of physical restraint and seclusion in psychiatric practice: Report of a survey

    Science.gov (United States)

    Khastgir, Udayan; Kala, Anirudh; Goswami, Utpal; Kumar, Satindra; Behera, Debakanta

    2003-01-01

    Restraint and seclusion has been used to manage patients despite all controversies. Our study analyzed the opinions of different psychiatrists on the use of this method in their clinical practice. Most of them (80%) practice restraints as a treatment modality and believe that they are integral to the management of psychiatric patients. None is using seclusion. PMID:21206846

  6. Dietary restraint in college women : Fear of an imperfect fat self is stronger than hope of a perfect thin self

    NARCIS (Netherlands)

    Dalley, Simon E.; Toffanin, Paolo; Pollet, Thomas V.

    2012-01-01

    We predicted that the perceived likelihood of acquiring a hoped-for thin self would mediate perfectionistic strivings on dietary restraint, and that the perceived likelihood of acquiring a feared fat self would mediate perfectionistic concerns on dietary restraint. We also predicted that the mediati

  7. Exploring perspectives on restraint during medical procedures in paediatric care: a qualitative interview study with nurses and physicians.

    Science.gov (United States)

    Svendsen, Edel Jannecke; Pedersen, Reidar; Moen, Anne; Bjørk, Ida Torunn

    2017-12-01

    The aim of this study was to explore nurses' and physicians' perspectives on and reasoning about the use of restraint during medical procedures on newly admitted preschoolers in somatic hospital care. We analysed qualitative data from individual interviews with a video recall session at the end with seven physicians and eight nurses. They had earlier participated in video recorded peripheral vein cannulations on preschool children. The data were collected between May 2012 and May 2013 at a paediatric hospital unit in Norway. The analysis resulted in three main themes: (1) disparate views on the concept of restraint and restraint use (2), ways to limit the use of physical restraint and its negative consequences, and (3) experience with the role of parents and their influence on restraint. Perspectives from both healthcare professions were represented in all the main themes and had many similarities. The results of this study may facilitate more informed and reflective discussions of restraint and contribute to higher awareness of restraint in clinical practice. Lack of guidance and scientific attention to restraint combined with conflicting interests and values among healthcare providers may result in insecurity, individual dogmatism, and a lack of shared discussions, language, and terminology.

  8. The External Restraints to Corporative Administration%外部约束下的公司治理

    Institute of Scientific and Technical Information of China (English)

    崔新有

    2004-01-01

    Corporative efficiency in operation and logic administration relies not only on the good functionality of internal control mechanism, but also on that of external management. Business administrators usually maintain that an ideal restricting mechanism involves internal stimulating tools as well as external restraints. This paper aims to analyze the factors in external, restraints, which leads to some feasible proposals.

  9. Analysis of Heart Rate and Self-Injury with and without Restraint in an Individual with Autism

    Science.gov (United States)

    Jennett, Heather; Hagopian, Louis P.; Beaulieu, Lauren

    2011-01-01

    The relation between self-injury and heart rate was analyzed for an individual who appeared anxious while engaging in self-injury. The analysis involved manipulating the presence or absence of restraint while simultaneously measuring heart rate. The following findings were obtained and replicated: (a) when some form of restraint was applied, heart…

  10. Quality of life of nursing-home residents with dementia subject to surveillance technology versus physical restraints: an explorative study.

    NARCIS (Netherlands)

    Boekhorst, S. te; Depla, M.F.I.A.; Francke, A.L.; Twisk, J.W.R.; Zwijsen, S.A.; Hertogh, C.M.P.M.

    2013-01-01

    Objective: As physical restraints should only be used in exceptional cases, there is an urgent need for alternatives to restraint use. Surveillance technology could be such an alternative. This study explored whether nursing-home residents with dementia subjected to surveillance technology had

  11. The legal regulation of seclusion and restraint in mental health facilities.

    Science.gov (United States)

    McSherry, Bernadette

    2013-12-01

    A recent report submitted to the United Nations Human Rights Council by the United Nations Special Rapporteur on Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment, has called for "an absolute ban" on the use of seclusion and restraint in mental health facilities. In Australia, seclusion and some, but not all, forms of restraint are regulated either by legislation or guidelines. This column explores some of the issues raised by the lack of national reporting requirements for these practices and moves by the National Mental Health Commission towards their reduction or elimination.

  12. 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 importance of accounting for body mass in research on the impact of dietary restraint on eating behaviors.

  13. Effect of forward/backward standing posture on foot shape

    NARCIS (Netherlands)

    Daanen, H.A.M.; Tan, T.K.; Punte, P.A.J.

    2000-01-01

    Foot length and breadth are generally used to determine the correct shoe size. An important question is whether foot length and foot breadth are dependent upon body posture. Therefore, the effect of leaning forward/backward on foot length and breadth is investigated in this study. Seven subjects

  14. Age-related differences in women's foot shape

    NARCIS (Netherlands)

    Ansuategui Echeita, Jone; Hijmans, Juha M.; Smits, Sharon; Van der Woude, Lucas H. V.; Postema, Klaas

    2016-01-01

    Purpose: Describe age-related differences in women's foot shape using a wide range of measurements and ages. Study design: Cross-sectional, observational study. Main outcome measurements: Six foot-shape measurements of each foot: foot lengths, ball widths, ball circumferences, low instep circumferen

  15. Effect of forward/backward standing posture on foot shape

    NARCIS (Netherlands)

    Daanen, H.A.M.; Tan, T.K.; Punte, P.A.J.

    2000-01-01

    Foot length and breadth are generally used to determine the correct shoe size. An important question is whether foot length and foot breadth are dependent upon body posture. Therefore, the effect of leaning forward/backward on foot length and breadth is investigated in this study. Seven subjects par

  16. Clinical and functional correlates of foot pain in diabetic patients.

    NARCIS (Netherlands)

    Rijken, P.M.; Dekker, J.; Rauwerda, J.A.; Dekker, E.; Lankhorst, G.J.; Bakker, K.; Dooren, J.

    1998-01-01

    Purpose: patients with diabetes mellitus frequently suffer from foot pain. This pain seems to be a neglected area in studies on the diabetic foot. The purpose of this study was to identify clinical variables associated with foot pain in diabetic patients. In addition, the relationships between foot

  17. 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

  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 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.

  19. The diabetic foot in 2015: an overview.

    Science.gov (United States)

    Markakis, K; Bowling, F L; Boulton, A J M

    2016-01-01

    In 2015, it can be said that the diabetic foot is no longer the Cinderella of diabetic complications. Thirty years ago there was little evidence-based research taking place on the diabetic foot, and there were no international meetings addressing this topic. Since then, the biennial Malvern Diabetic Foot meetings started in 1986, the American Diabetes Association founded their Foot Council in 1987, and the European Association for the Study of Diabetes established a Foot Study Group in 1998. The first International Symposium on the Diabetic Foot in The Netherlands was convened in 1991, and this was soon followed by the establishment of the International Working Group on the Diabetic Foot that has produced useful guidelines in several areas of investigation and the management of diabetic foot problems. There has been an exponential rise in publications on diabetic foot problems in high impact factor journals, and a comprehensive evidence-base now exists for many areas of treatment. Despite the extensive evidence available, it, unfortunately, remains difficult to demonstrate that most types of education are efficient in reducing the incidence of foot ulcers. However, there is evidence that education as part of a multi-disciplinary approach to diabetic foot ulceration plays a pivotal role in incidence reduction. With respect to treatment, strong evidence exists that offloading is the best modality for healing plantar neuropathic foot ulcers, and there is also evidence from two randomized controlled trials to support the use of negative-pressure wound therapy in complex post-surgical diabetic foot wounds. Hyperbaric oxygen therapy exhibits the same evidence level and strength of recommendation. International guidelines exist on the management of infection in the diabetic foot. Many randomized trials have been performed, and these have shown that the agents studied generally produced comparable results, with the exception of one study in which tigecycline was shown to

  20. Intramedullary foot fixation for midfoot Charcot neuroarthropathy.

    Science.gov (United States)

    Lamm, Bradley M; Siddiqui, Noman A; Nair, Ajitha K; LaPorta, Guido

    2012-01-01

    Midfoot Charcot collapse commonly occurs through the tarsometatarsal and/or midtarsal joints, which creates the characteristic "rocker bottom" deformity. Intramedullary metatarsal fixation spanning the tarsus into the talus and/or calcaneus is a recently developed method for addressing unstable midfoot Charcot deformity. The intramedullary foot fixation technique has various advantages when addressing midfoot Charcot deformity in the neuropathic patient. These advantages include anatomical realignment, minimally invasive fixation technique, formal multiple joint fusion, adjacent joint fixation beyond the level of Charcot collapse, rigid interosseus fixation, and preservation of foot length. The goals of the intramedullary foot fixation procedure are to create a stable, plantigrade, and ulcer-free foot, which allows the patient to ambulate with custom-molded orthotics and shoes.

  1. [Diabetic, neuropathic, arteriopathic foot and dressing choice].

    Science.gov (United States)

    Lowe, S; Kayoumi, M

    2012-11-14

    The definition for the diabetic foot is infection, ulceration or destruction of deep tissues of the foot associated with neuropathy or peripheral vascular disease in the lower extremity of people with diabetes. Non-diabetic patients may suffer the same risks when neuropathy and arteriopathy are present. Knowing that 85% of amputations are preceded by foot ulcers, prevention is primordial. At the onset of an ulcer, immediate treatment must be undertaken and preferably by an interdisciplinary team. Delayed healing and increased risk of infection are often due to an associated vascular disease. While the array of dressings is expansive there is no «gold standard» treatment or «miracle dressing» described for foot ulcers. The management consists of wound analysis, debridement, woundcare and especially offloading.

  2. Diabetic foot ulcer management: the podiatrist's perspective.

    Science.gov (United States)

    Turns, Martin

    2013-12-01

    Diabetic foot complications result from two broad pathologies-neuropathic and neuro-ischaemic feet. It is important for diabetic patients to have at least a yearly review of foot ulcer risk factors, and they should have a corresponding risk classification agreed based on this assessment. Diabetic foot ulcer assessment should include a wound classification tool, which can give an indication of wounds at greater risk of non-healing or amputation. The treatment of diabetic foot ulcers should be part of a comprehensive care plan that should also include treatment of infection, frequent debridement (if deemed appropriate by a skilled specialist clinician), biomechanical offloading, blood glucose control and treatment of comorbidities. Clinicians should base dressing selection on the wound's location, size and depth, amount of exudate, presence of infection or necrosis and the condition of the surrounding tissue.

  3. Glossary of Foot and Ankle Terms

    Science.gov (United States)

    ... of Charcot fractures in the foot and ankle. Orthopaedics/Orthopedics - The medical and surgical specialty focused on treating, repairing and reconstructing the human musculoskeletal system. Orthopaedist /Orthopaedic Surgeon - A surgeon whose specialty is treating, repairing ...

  4. Habitual physical activity, peripheral neuropathy, foot deformities ...

    African Journals Online (AJOL)

    Function Scale, and a self-designed foot deformity audit form. .... categorised under: Work activity – assesses physical activity level .... married and more than half (59%) were in paid employment. ..... walking patterns of the diabetic groups.

  5. American College of Foot and Ankle Surgeons

    Science.gov (United States)

    ... Practice Management Education Opportunities Practice Management e-Learning e-Learning CME Transcripts Corporate Relations Faculty Application Research & Publications Journal of Foot and Ankle Surgery ACFAS Update Read ...

  6. On-the-Job Foot Health

    Science.gov (United States)

    ... and direct flame PROTECTION: overshoes or boots of fire-resistant materials with wooden soles HAZARD: high voltage ... in the workplace. Only one out of four victims of job- related foot injury wear any type ...

  7. Angiography in the region of the foot

    Energy Technology Data Exchange (ETDEWEB)

    Zeitler, E.

    1984-06-01

    It is reported on technique, incidence and findings of angiography of the foot which provided magnifying angiography and non-ionic contrast media are used, is especially qualified for the differentiation of diabetic and non-diabetic angiopathies as well as for the identification of peripherical embolizations and digital arterial occlusions at thrombocytosis or polycythemia. The arteries of the foot represent the peripherical outflow at peripherical reconstructive performances at the lower leg and have to be studied prior to such reconstructive surgical interventions. The different localization of arterial obliterations and changes of the walls in diabetics of stage I-IV according to Fontaine shows the particularly large number of vascular-pathological findings in arteries of the lower leg and foot in diabetics with arterial occlusive diseases of stage III and IV. Therefore, the unfavourable prognoses of arterial occlusive diseases in diabetics have also to be made for peripherical arterial obliterations of the foot and lower leg.

  8. Leg or foot amputation - dressing change

    Science.gov (United States)

    ... gov/ency/patientinstructions/000018.htm Leg or foot amputation - dressing change To use the sharing features on ... guideline for management for rehabilitation of lower limb amputation. January 2008. www.healthquality.va.gov/guidelines/Rehab/ ...

  9. Charcot foot and ankle with osteomyelitis

    OpenAIRE

    Donegan, Ryan; Sumpio, Bauer; Peter A. Blume

    2013-01-01

    This paper presents a review of the current literature discussing topics of Charcot osteoarthropathy, osteomyelitis, diagnosing osteomyelitis, antibiotic management of osteomyelitis, and treatment strategies for management of Charcot osteoarthropathy with concurrent osteomyelitis.Keywords: Charcot foot; osteomyelitis; diabetes mellitus; infection; neuropathy(Published: 1 October 2013)Citation: Diabetic Foot & Ankle 2013, 4: 21361 - http://dx.doi.org/10.3402/dfa.v4i0.21361

  10. Postoperative infection in the foot and ankle.

    LENUS (Irish Health Repository)

    Chan, Victoria O

    2012-07-01

    Our discussion highlights the commonly performed surgical procedures in the foot and ankle and reviews the various imaging modalities available for the detection of infection with graphic examples to better enable radiologists to approach the radiological evaluation of postoperative infection in the foot and ankle. Discrimination between infectious and noninfectious inflammation remains a diagnostic challenge usually needing a combination of clinical assessment, laboratory investigations, and imaging studies to increase diagnostic accuracy.

  11. The landmine foot: its description and management.

    Science.gov (United States)

    Jacobs, L G

    1991-11-01

    The injuries of 54 patients involved in landmine explosions are described. In 72 per cent the injuries affected the mid- and hindfoot. Of these injuries, 67 per cent were open fractures involving the calcaneus. The injury resulted in the 'landmine foot', an entity not previously described. Its clinical features and orthotic management are described. The prognosis of 'landmine foot' was generally favourable in this Third World setting, with adequate rehabilitation provided by a customized surgical boot.

  12. A dynamic 3D foot reconstruction system.

    Science.gov (United States)

    Thabet, Ali K; Trucco, Emanuele; Salvi, Joaquim; Wang, Weijie; Abboud, Rami J

    2011-01-01

    Foot problems are varied and range from simple disorders through to complex diseases and joint deformities. Wherever possible, the use of insoles, or orthoses, is preferred over surgery. Current insole design techniques are based on static measurements of the foot, despite the fact that orthoses are prevalently used in dynamic conditions while walking or running. This paper presents the design and implementation of a structured-light prototype system providing dense three dimensional (3D) measurements of the foot in motion, and its use to show that foot measurements in dynamic conditions differ significantly from their static counterparts. The input to the system is a video sequence of a foot during a single step; the output is a 3D reconstruction of the plantar surface of the foot for each frame of the input. Engineering and clinical tests were carried out for the validation of the system. The accuracy of the system was found to be 0.34 mm with planar test objects. In tests with real feet, the system proved repeatable, with reconstruction differences between trials one week apart averaging 2.44 mm (static case) and 2.81 mm (dynamic case). Furthermore, a study was performed to compare the effective length of the foot between static and dynamic reconstructions using the 4D system. Results showed an average increase of 9 mm for the dynamic case. This increase is substantial for orthotics design, cannot be captured by a static system, and its subject-specific measurement is crucial for the design of effective foot orthoses.

  13. The management of the infected diabetic foot.

    Science.gov (United States)

    Caravaggi, Carlo; Sganzaroli, Adriana; Galenda, Paolo; Bassetti, Matteo; Ferraresi, Roberto; Gabrielli, Livio

    2013-01-01

    Diabetes is a chronic disease with a worldwide increasing trend. Foot complications, closely related to neuropathy and obstructive peripheral vascular disease, are responsible for more than 1 million of leg amputations every year. Foot infection can dramatically increase the risk of amputation. Although many ulcer classification systems have been proposed to stratify the severity of the infectious process, the definition of a specific therapeutic approach still remains an unsolved problem. A Diabetic Foot Triage and an Integrated Surgical Protocol are proposed to identify a diagnostic flowchart and a step-by-step surgical protocol that can be applied in the treatment of diabetic foot infection. Considering the rapid climbing of multidrug resistant strains it is very important to rationalize the use of antibiotics utilizing them only for the treatment of true infected ulcers. PAD is widely considered the most important factor conditioning the outcome of a diabetic foot ulcer. Currently no randomized control trials are reported in the international literature directly comparing open versus endovascular revascularisation in diabetic patients with CLI. Insufficient data are available to demonstrate whether open bypass surgery or endovascular interventions are more effective in these patients. A decisional flow chart in choosing the best revascularization strategy in diabetic patients with CLI is proposed. Goals and technical aspects of emergency and elective surgical procedures in diabetic foot are analysed to evaluate critical aspects and to suggest proper surgical choices.

  14. The Charcot foot: pathophysiology, diagnosis and classification.

    Science.gov (United States)

    Trieb, K

    2016-09-01

    Neuropathic changes in the foot are common with a prevalence of approximately 1%. The diagnosis of neuropathic arthropathy is often delayed in diabetic patients with harmful consequences including amputation. The appropriate diagnosis and treatment can avoid an extensive programme of treatment with significant morbidity for the patient, high costs and delayed surgery. The pathogenesis of a Charcot foot involves repetitive micro-trauma in a foot with impaired sensation and neurovascular changes caused by pathological innervation of the blood vessels. In most cases, changes are due to a combination of both pathophysiological factors. The Charcot foot is triggered by a combination of mechanical, vascular and biological factors which can lead to late diagnosis and incorrect treatment and eventually to destruction of the foot. This review aims to raise awareness of the diagnosis of the Charcot foot (diabetic neuropathic osteoarthropathy and the differential diagnosis, erysipelas, peripheral arterial occlusive disease) and describe the ways in which the diagnosis may be made. The clinical diagnostic pathways based on different classifications are presented. Cite this article: Bone Joint J 2016;98-B:1155-9.

  15. THE MADURA FOOT - A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Nazimuddin Mohammad

    2011-04-01

    Full Text Available Madura foot or mycetoma is a chronic granulomatous disease characterized by localized infection of subcutaneous tissues by actinomycetes or fungi. The inflammatory response can extend to the underlying bone. Mycetoma was described first in the mid 1800s and was initially called Madura foot. The infection can be caused by true fungi (eumycetoma in 40%, or filamentous bacteria (actinomycetoma in 60%.Actinomycetoma may be due to Actinomadura madurae, Actinomadura pelletieri, Streptomyces somaliensis, Nocardia species. The infection, which may remain latent for a time, forms small, subcutaneous swellings that enlarge, soften with pus, and break through the skin surface, with concurrent invasion of deeper tissues. Sulfonamide, iodide, and antibiotic therapy have been used against actinomycotic infections, but the fungi are more resistant to treatment. We reported a patient of madura foot from International Medical College Hospital, Tongi, Gazipur. A 82-years old male was admitted to the International medical college hospital with a 16 months history of swelling with multiple discharging sinuses filled with granules localized in his right foot. Pus was examined by gram staining and periodic acid Schiff (PAS staining. Moderate number of filamentous branching gram positive bacilli were found . The organism was recognized as a member of the actinomyces genus. PAS staining did not reveal any other organism. The aggressive course and progression of the disease affected the short bones of the involved foot. The patient was diagnosed as a case of Madura foot and was treated in the same hospital.

  16. The growth of foot arches and influencing factors

    OpenAIRE

    Ferial Hadipoetro Idris

    2016-01-01

    Background Foot arches are important components for body sup- port. Foot arch deformity caused by growth abnormalities cause serious limitations in daily activities. Objectives To determine the patterns of foot arch growth, factors influencing foot arch growth, and the timing for intervention in er- rant growth patterns. Methods A cross-sectional study evaluated the foot arches of chil- dren aged 0-18 years according to age and sex. Subjects included had no evidence of...

  17. Review of State Policies Concerning the Use of Physical Restraint Procedures in Schools

    Science.gov (United States)

    Ryan, Joseph B.; Robbins, Katherine; Peterson, Reece; Rozalski, Michael

    2009-01-01

    Recent injuries and fatalities among students due to the use of physical restraint procedures in schools, and the resulting media attention and litigation have started to place pressure on many state and local education agencies to develop policies or guidelines concerning their use in schools. The authors investigated existing state policies and…

  18. Pasung: Physical restraint and confinement of the mentally ill in the community

    Directory of Open Access Journals (Sweden)

    Diatri Hervita

    2008-06-01

    Full Text Available Abstract Background Physical restraint and confinement (pasung by families of people with mental illness is known to occur in many parts of the world but has attracted limited investigation. This preliminary observational study was carried out on Samosir Island in Sumatra, Indonesia, to investigate the nature of such restraint and confinement, the clinical characteristics of people restrained, and the reasons given by families and communities for applying such restraint. Methods The research method was cross-sectional observational research in a natural setting, carried out during a six-month period of working as the only psychiatrist in a remote district. Results Fifteen cases of pasung, approximately even numbers of males and females and almost all with a diagnosis of schizophrenia were identified. Duration of restraint ranged from two to 21 years. Discussion and Conclusion The provision of basic community mental health services, where there were none before, enabled the majority of the people who had been restrained to receive psychiatric treatment and to be released from pasung.

  19. Service Users' Views of Physical Restraint Procedures in Secure Settings for People with Learning Disabilities

    Science.gov (United States)

    Jones, Peter; Kroese, Biza Stenfert

    2007-01-01

    The appropriateness and justification of physical restraint procedures in secure learning disability settings is an emotive issue. This paper examines the views of service users (n = 10) from secure residential facilities who are restrained frequently. Using a semi-structured interview schedule, Service users were interviewed about their restraint…

  20. Positive School-Wide Interventions for Eliminating Physical Restraint and Exclusion.

    Science.gov (United States)

    Fogt, Julie B.; Piripavel, Christine M.

    2002-01-01

    This article describes a school where problems of defiance and aggression were met with high levels of seclusion and physical restraints. Centennial School had a comprehensive program of interventions designed to reduce and eventually eliminate aversive management strategies. Data on the effectiveness of these interventions is shared and…

  1. Investigating the Impact of School Administrator's on the Frequency of Physical Restraint in K-12 Schools

    Science.gov (United States)

    Dowell, Richard; Larwin, Karen

    2016-01-01

    The purpose of a physical restraint is to control the behavior of a student. It can involve physically holding a person immobile against his or her will to using chemical or mechanical devices to control a person. This study was designed to contribute to the paucity of existing research literature in regards to a school administrator's impact on…

  2. Assistive technology as an alternative to physical restraints in psychogeriatric nursing homes.

    NARCIS (Netherlands)

    Zwijsen, S.; Boekhorst, S. te; Hertogh, C.; Francke, A.

    2010-01-01

    Introduction: Assistive technology is proposed as an alternative to physical restraints in nursing home care for people with dementia. The number of nursing homes implementing assistive technology is steadily rising. However, research on usability is lacking. Objectives: This mixed methods study

  3. Pasung: Physical restraint and confinement of the mentally ill in the community

    Science.gov (United States)

    Minas, Harry; Diatri, Hervita

    2008-01-01

    Background Physical restraint and confinement (pasung) by families of people with mental illness is known to occur in many parts of the world but has attracted limited investigation. This preliminary observational study was carried out on Samosir Island in Sumatra, Indonesia, to investigate the nature of such restraint and confinement, the clinical characteristics of people restrained, and the reasons given by families and communities for applying such restraint. Methods The research method was cross-sectional observational research in a natural setting, carried out during a six-month period of working as the only psychiatrist in a remote district. Results Fifteen cases of pasung, approximately even numbers of males and females and almost all with a diagnosis of schizophrenia were identified. Duration of restraint ranged from two to 21 years. Discussion and Conclusion The provision of basic community mental health services, where there were none before, enabled the majority of the people who had been restrained to receive psychiatric treatment and to be released from pasung. PMID:18554420

  4. EFFECT OF PHYSICAL RESTRAINT ON THE LIMITS OF THERMOREGULATION IN TELEMETERED RATS

    Science.gov (United States)

    Physical restraint of rodents is needed for nose-only exposure to airborne toxicants and is also used as a means ofpsychological stress. Hyperthermia is often observed in restrained rats, presumably as a result of impairments in heat dissipation. However, such a hyperthermic resp...

  5. The Eileen Skellern Lecture 2014: physical restraint: in defence of the indefensible?

    Science.gov (United States)

    Duxbury, J A

    2015-03-01

    Aggression is reported to be prevalent in psychiatric inpatient care and its frequency towards healthcare professionals is well documented. While aggression may not be entirely avoidable, its incidence can be reduced through prevention and the minimization of restrictive practices such as physical restraint. The study aims to explore three common 'defences' to account for the use of physical restraint; to challenge each defence with regard to the evidence base; and to identify how services are responding to the challenge of reducing the use of restrictive interventions. Following a number of investigations to highlight serious problems with the use of physical restraint, it seems timely to examine its efficacy in light of the evidence base. In order to do this, three key defences for its use will be challenged using the literature. A combination of interventions to minimize the use of restraint including advance planning tools, and recognition of potential trauma is necessary at an organizational and individual level. Patients can be severely traumatized by the use of restrictive practices and there is a drive to examine, and reduce the use and impact of using these models that incorporate trauma informed care (TIC) and person centredness. © 2015 John Wiley & Sons Ltd.

  6. Transient influence of end-tidal carbon dioxide tension on the postural restraint in cerebral perfusion

    NARCIS (Netherlands)

    R.V. Immink; J. Truijen; N.H. Secher; J.J. van Lieshout

    2009-01-01

    Immink RV, Truijen J, Secher NH, Van Lieshout JJ. Transient influence of end-tidal carbon dioxide tension on the postural restraint in cerebral perfusion. J Appl Physiol 107: 816-823, 2009. First published July 2, 2009; doi: 10.1152/japplphysiol.91198.2008.-In the upright position, cerebral blood fl

  7. A Ban on Prior Restraint in High Schools: The Aftermath of the "Fujishima" Decision.

    Science.gov (United States)

    Trager, Robert; Dickerson, Donna L.

    After a unique court decision forbidding prior restraint in public high school publications in three states, a study was devised based on the responses to individual questionnaires sent to principals, faculty advisers, and student editors in each of the schools in the judicial district involved in the decision. Respondents answered questions…

  8. Judicial Restraints on the Press. Freedom of Information Foundation Series No. 2.

    Science.gov (United States)

    Gillmor, Donald M.

    The purpose of this paper is to examine the current status of freedom of the press with regard to past and present judicial rulings. A section devoted to "The Background of Prior Restraint" examines the historical basis for current legal decisions. In "Threatening Progeny," court decisions unfriendly to the press such as the Reardon Report, the…

  9. 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.

  10. Executive-level reviews of seclusion and restraint promote interdisciplinary collaboration and innovation.

    Science.gov (United States)

    Allen, Diane E; de Nesnera, Alexander; Souther, Justin W

    2009-08-01

    Elimination of seclusion and restraint requires support at all levels of an organization, especially from leaders who visibly champion and communicate their vision. Nurses, physicians, educators, and administrators at New Hampshire Hospital, an acute psychiatric inpatient facility, have established a standard meeting time and place for an executive-level review of every episode of seclusion and restraint. The standing meeting demonstrates the organization's commitment to caring for both patients and staff. The daily meetings foster a spirit of interdisciplinary collaboration, where direct care staff have the opportunity to tell their stories and share their ideas and concerns in an environment that is caring, supportive, and devoid of criticism or blame. Narrative descriptions of emergency interventions, including what was learned from debriefings with patients and staff involved, provide data about factors that may contribute to the use of seclusion or restraint. This forum provides visible administrative and clinical support that promotes creative thinking, collaborative problem solving, and the exploration of new ideas recommended by those directly involved in providing patient care. It has fostered exploration and development of strategies that have minimized episodes of aggressive behavior as well as seclusion and restraint.

  11. Manual restraint and common compound administration routes in mice and rats.

    Science.gov (United States)

    Machholz, Elton; Mulder, Guy; Ruiz, Casimira; Corning, Brian F; Pritchett-Corning, Kathleen R

    2012-09-26

    Being able to safely and effectively restrain mice and rats is an important part of conducting research. Working confidently and humanely with mice and rats requires a basic competency in handling and restraint methods. This article will present the basic principles required to safely handle animals. One-handed, two-handed, and restraint with specially designed restraint objects will be illustrated. Often, another part of the research or testing use of animals is the effective administration of compounds to mice and rats. Although there are a large number of possible administration routes (limited only by the size and organs of the animal), most are not used regularly in research. This video will illustrate several of the more common routes, including intravenous, intramuscular, subcutaneous, and oral gavage. The goal of this article is to expose a viewer unfamiliar with these techniques to basic restraint and substance administration routes. This video does not replace required hands-on training at your facility, but is meant to augment and supplement that training.

  12. 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.

  13. 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…

  14. Self-Injurious Behavior, Self-Restraint, and Compulsive Behaviors in Cornelia de Lange Syndrome.

    Science.gov (United States)

    Hyman, Philippa; Oliver, Chris; Hall, Scott

    2002-01-01

    Analysis of questionnaires completed by caregivers of 77 individuals with Cornelia de Lange syndrome in the United Kingdom found a significant association between self-injurious behaviors and self-restraint, and those displaying both behaviors displayed significantly more compulsions than did those not exhibiting them. Findings extend the…

  15. Applying sensory modulation to mental health inpatient care to reduce seclusion and restraint

    DEFF Research Database (Denmark)

    Andersen, Charlotte; Kolmos, Anne; Andersen, Kjeld

    2017-01-01

    with the control group. RESULTS: The use of belts decreased with 38% compared to the control group. The use of forced medication decreased with 46% compared to the control group. Altogether the use of physical restraint and forced medication decreased significantly with 42% (p 

  16. Charge-density analysis of 1-nitroindoline: refinement quality using free R factors and restraints.

    Science.gov (United States)

    Zarychta, Bartosz; Zaleski, Jacek; Kyzioł, Janusz; Daszkiewicz, Zdzisław; Jelsch, Christian

    2011-06-01

    Nitramines and related N-nitro compounds have attracted significant attention owing to their use in rocket fuel and as explosives. The charge density of 1-nitroindoline was determined experimentally and from theoretical calculations. Electron-density refinements were performed using the multipolar atom formalism. In order to design the ideal restraint strategy for the charge-density parameters, R-free analyses were performed involving a series of comprehensive refinements. Different weights were applied to the charge-density restraints, namely the similarity between chemically equivalent atoms and local symmetry. Additionally, isotropic thermal motion and an anisotropic model calculated by rigid-body analysis were tested on H atoms. The restraint weights which resulted in the lowest values of the averaged R-free factors and the anisotropic H-atom model were considered to yield the best charge density and were used in the final refinement. The derived experimental charge density along with intra- and intermolecular interactions was analysed and compared with theoretical calculations, notably with respect to the symmetry of multipole parameters. A comparison of different refinements suggests that the appropriate weighting scheme applied to charge-density restraints can reduce the observed artefacts. The topological bond orders of the molecule were calculated.

  17. 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.

  18. 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.

  19. Effects of the chronic restraint stress induced depression on reward-related learning in rats.

    Science.gov (United States)

    Xu, Pan; Wang, Kezhu; Lu, Cong; Dong, Liming; Chen, Yixi; Wang, Qiong; Shi, Zhe; Yang, Yanyan; Chen, Shanguang; Liu, Xinmin

    2017-03-15

    Chronic mild or unpredictability stress produces a persistent depressive-like state. The main symptoms of depression include weight loss, despair, anhedonia, diminished motivation and mild cognition impairment, which could influence the ability of reward-related learning. In the present study, we aimed to evaluate the effects of chronic restraint stress on the performance of reward-related learning of rats. We used the exposure of repeated restraint stress (6h/day, for 28days) to induce depression-like behavior in rats. Then designed tasks including Pavlovian conditioning (magazine head entries), acquisition and maintenance of instrumental conditioning (lever pressing) and goal directed learning (higher fixed ratio schedule of reinforcement) to study the effects of chronic restraint stress. The results indicated that chronic restraint stress influenced rats in those aspects including the acquisition of a Pavlovian stimulus-outcome (S-O) association, the formation and maintenance of action-outcome (A-O) causal relation and the ability of learning in higher fixed ratio schedule. In conclusion, depression could influence the performances in reward-related learning obviously and the series of instrumental learning tasks may have potential as a method to evaluate cognitive changes in depression.

  20. 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…

  1. 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…

  2. Restraint and Cancellation: Multiple Inhibition Deficits in Attention Deficit Hyperactivity Disorder

    Science.gov (United States)

    Schachar, Russell; Logan, Gordon D.; Robaey, Philippe; Chen, Shirley; Ickowicz, Abel; Barr, Cathy

    2007-01-01

    We used variations of the stop signal task to study two components of motor response inhibition--the ability to withhold a strong response tendency (restraint) and the ability to cancel an ongoing action (cancellation)--in children with a diagnosis of attention deficit hyperactivity disorder (ADHD) and in non-ADHD controls of similar age (ages…

  3. Reducing Seclusion Timeout and Restraint Procedures with At-Risk Youth

    Science.gov (United States)

    Ryan, Joseph B.; Peterson, Reece; Tetreault, George; Hagen, Emily Vander

    2007-01-01

    The purpose of this pilot study was to review the effects of professional staff training in crisis management and de-escalation techniques on the use of seclusion timeout and restraint procedures with at-risk students in a K-12 special day school. An exploratory pre-post study was conducted over a two-year period, comparing the use of these…

  4. Reduction of Restraint of People with Intellectual Disabilities: An Organizational Behavior Management (OBM) Approach

    Science.gov (United States)

    Williams, Don E.; Grossett, Deborah L.

    2011-01-01

    We used an organizational behavior management (OBM) approach to increase behavior intervention plans and decrease the use of mechanical restraint. First, recipients were tracked as a member of the priority group if they engaged in frequent self-injurious behavior or physical aggression toward others and/or if they had been placed in mechanical…

  5. Restraint of Statehood and the Quality of Governance by Multinational Companies in Sub-Saharan Africa

    NARCIS (Netherlands)

    Hoenke, Jana; Börzel, Tanja A.

    2013-01-01

    This paper explores to what extent the quality of governance by MNC in areas of limited statehood depends on the limitation, and, more importantly, on the restraint of statehood. The control over the monopoly of force and a minimum of state capacity to set and enforce rules are only one condition

  6. 'It's part of the job, but it spoils the job': a phenomenological study of physical restraint.

    Science.gov (United States)

    Bigwood, Stuart; Crowe, Marie

    2008-06-01

    This paper examines mental health nurses' experiences of physical restraint in an acute inpatient psychiatric setting using Van Manen's descriptive hermeneutic phenomenological methodology. The aim was to understand the nurses' experiences of physical restraint. One overarching theme emerged from the analysis: It's part of the job. This theme had a subtheme of Control which was constituted by the Conflicted Nurse and the Scared Nurse. The findings suggest that mental health nurses are very uncomfortable with physical restraint despite it being taken-for-granted as integral to their role. The nurses experienced conflict and fear associated with the procedure and would prefer to utilize other de-escalation skills if it was possible. The main source of conflict related to the imperative to maintain control and the professional values of the therapeutic relationship. While the nurses could see no viable alternative in some situations, the paper concludes that while environmental issues impact on the practice of physical restraint mental health nurses need to practice it with as much care and humanity as possible.

  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. 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.

  9. The influence of foot orthoses on foot mobility magnitude and arch height index in adults with flexible flat feet.

    Science.gov (United States)

    Sheykhi-Dolagh, Roghaye; Saeedi, Hassan; Farahmand, Behshid; Kamyab, Mojtaba; Kamali, Mohammad; Gholizadeh, Hossein; Derayatifar, Amir A; Curran, Sarah

    2015-06-01

    Flexible flat foot is described as a reduction in the height of the medial longitudinal arch and may occur from abnormal foot pronation. A foot orthosis is thought to modify and control excessive pronation and improve arch height. To compare the immediate effect of three types of orthoses on foot mobility and the arch height index in subjects with flexible flat feet. A quasi-experimental study. The dorsal arch height, midfoot width, foot mobility and arch height index were assessed in 20 participants with flexible flat feet (mean age = 23.2 ± 3 years) for three different foot orthosis conditions: soft, semi-rigid and rigid University of California Biomechanics Laboratory (UCBL). Maximum midfoot width at 90% with arch mobility in the coronal plane was shown in the semi-rigid orthosis condition. The semi-rigid orthosis resulted in the highest mean foot mobility in 90% of weight bearing, and the rigid orthosis (UCBL) had the lowest mean foot mobility. The soft orthosis resulted in foot mobility between that of the rigid and the semi-rigid orthosis. UCBL orthosis showed the highest arch height index, and the semi-rigid orthosis showed the lowest mean arch height index. Due to its rigid structure and long medial-lateral walls, the UCBL orthosis appears to limit foot mobility. Therefore, it is necessary to make an orthosis that facilitates foot mobility in the normal range of the foot arch. Future studies should address the dynamic mobility of the foot with using various types of foot orthoses. Although there are many studies focussed on flat foot and the use of foot orthoses, the mechanism of action is still unclear. This study explored foot mobility and the influence of foot orthoses and showed that a more rigid foot orthosis should be selected based on foot mobility. © The International Society for Prosthetics and Orthotics 2014.

  10. Movement of the human foot in 100 pain free individuals aged 18–45: implications for understanding normal foot function

    OpenAIRE

    Nester, Christopher J; Jarvis, Hannah L; Jones, Richard K; Bowden, Peter D; Liu, Anmin

    2014-01-01

    Background Understanding motion in the normal healthy foot is a prerequisite for understanding the effects of pathology and thereafter setting targets for interventions. Quality foot kinematic data from healthy feet will also assist the development of high quality and research based clinical models of foot biomechanics. To address gaps in the current literature we aimed to describe 3D foot kinematics using a 5 segment foot model in a population of 100 pain free individuals. Methods Kinematics...

  11. Knowledge, attitude and practice of intensive care unit nurses about physical restraint.

    Science.gov (United States)

    Suliman, Mohammad; Aloush, Sami; Al-Awamreh, Khitam

    2017-09-01

    Physical restraint is mainly used in intensive care units (ICUs) to prevent delirious or agitated patients from removing tubes and lines connected to them. However, inappropriate use of physical restraint could have many detrimental physical effects on the patient, such as nerve damage, asphyxiation or even death. The aim of the study is to investigate nurses' knowledge, attitude and practice of physical restraint in ICUs in Jordanian hospitals, about which little is known. A descriptive and cross-sectional design was used. A convenience sample of 400 nurses working in three public hospitals and one university-affiliated hospital from different geographical regions in Jordan was selected. An Arabic version of the Physical Restraint Questionnaire (PRQ) was used to collect the data. A total of 300 completed questionnaires were returned, with a response rate of 75%. Of the total sample, 51% were males, 65.7% were from public hospitals and 80.3% held a bachelor's degree. The mean score in the knowledge section was 9.7 (SD =1.7) out of 15; in the attitude section, it was 24.7 (SD = 4.8) out of 33; and in the practice section, it was 30.9 (SD = 3.5) out of 42. Nurses who reported previous related education scored higher on the knowledge section (mean = 10.7; SD = 1.4) than nurses who reported no previous related education (mean = 9.1; SD = 1.6; p < .001). However, no significant differences between these categories were found in relation to attitude and practice. The study demonstrated some lack of knowledge and unsafe practices regarding physical restraint in ICUs in Jordan. It suggests improving nurses' knowledge, attitude and practices through in-service education on best practice for physical restraint, developing policies/guidelines and providing adequate staff and equipment to maintain patient safety and prevent complications. Conducting education programmes on physical restraint for ICU nurses and providing other preventive strategies

  12. 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

  13. The forgotten foot - an assessment of foot and ankle radiograph pathology in final year medical students.

    LENUS (Irish Health Repository)

    Groarke, P J

    2014-04-27

    It has been shown that doctors in Emergency Departments (EDs) have inconsistent knowledge of musculoskeletal anatomy. This is most likely due to a deficiency in focused musculoskeletal modules at undergraduate level in medical school. The aims of this study were to evaluate the knowledge of final year medical students on foot anatomy and common foot and ankle pathology as seen on radiographs.

  14. Foot lengthening and shortening during gait: a parameter to investigate foot function?

    NARCIS (Netherlands)

    Stolwijk, N.M.; Koenraadt, K.L.M.; Louwerens, J.W.; Grim, D.; Duysens, J.E.J.; Keijsers, N.L.W.

    2014-01-01

    INTRODUCTION: Based on the windlass mechanism theory of Hicks, the medial longitudinal arch (MLA) flattens during weight bearing. Simultaneously, foot lengthening is expected. However, changes in foot length during gait and the influence of walking speed has not been investigated yet. METHODS: The

  15. Foot lengthening and shortening during gait: a parameter to investigate foot function?

    NARCIS (Netherlands)

    Stolwijk, N.M.; Koenraadt, K.L.M.; Louwerens, J.W.; Grim, D.; Duysens, J.E.J.; Keijsers, N.L.W.

    2014-01-01

    INTRODUCTION: Based on the windlass mechanism theory of Hicks, the medial longitudinal arch (MLA) flattens during weight bearing. Simultaneously, foot lengthening is expected. However, changes in foot length during gait and the influence of walking speed has not been investigated yet. METHODS: The f

  16. Diagnostics and treatment of the diabetic foot.

    Science.gov (United States)

    Apelqvist, Jan

    2012-06-01

    Every 30 s, a lower limb is amputated due to diabetes. Of all amputations in diabetic patients 85% are preceded by a foot ulcer which subsequently deteriorates to a severe infection or gangrene. There is a complexity of factors related to healing of foot ulcers including strategies for treatment of decreased perfusion, oedema, pain, infection, metabolic disturbances, malnutrition, non-weight bearing, wound treatment, foot surgery, and management of intercurrent disease. Patients with diabetic foot ulcer and decreased perfusion do often not have rest pain or claudication and as a consequence non-invasive vascular testing is recommended for early recognition of ulcers in need of revascularisation to achieve healing. A diabetic foot infection is a potentially limb-threatening condition. Infection is diagnosed by the presence or increased rate of signs inflammation. Often these signs are less marked than expected. Imaging studies can diagnose or better define deep, soft tissue purulent collections and are frequently needed to detect pathological findings in bone. The initial antimicrobial treatment as well as duration of treatment is empiric. There is a substantial delay in wound healing in diabetic foot ulcer which has been related to various abnormalities. Several new treatments related to these abnormalities have been explored in wound healing with various successes. An essential part of the strategy to achieve healing is an effective offloading. Many interventions with advanced wound management have failed due to not recognizing the need for effective offloading. A multidisciplinary approach to wounds and foot ulcer has been successfully implemented in different centres with a substantial decrease in amputation rate.

  17. 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.

  18. 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.

  19. Early pharmacological treatment of delirium may reduce physical restraint use: a retrospective study.

    Science.gov (United States)

    Michaud, Christopher J; Thomas, Wendy L; McAllen, Karen J

    2014-03-01

    Evidence surrounding pharmacological treatment of delirium is limited. The negative impact of physical restraints on patient outcomes in the intensive care unit (ICU), however, is well published. The objective of this study was to evaluate whether initiating pharmacologic delirium treatment within 24 hours of a positive screen reduces the number of days in physical restraints and improves patient outcomes compared with delayed or no treatment. Patients from a mixed ICU with a documented positive delirium score using the Intensive Care Delirium Screening Checklist were retrospectively grouped based on having received pharmacologic treatment within 24 hours of the first positive screen or not. Primary end points were number of days spent in physical restraints and time to extubation after delirium onset. Secondary end points included hospital and ICU length of stay (LOS) and survival to discharge. Two hundred intubated patients were either pharmacologically treated (n = 98) or not treated (n = 102) within 24 hours of the first positive delirium score. Patients receiving treatment spent a shorter median time in restraints compared with patients who were not treated (3 vs 6 days; P < .001), and had a shorter median time to extubation (3 vs 6.5 days; P < .001). The treatment group also experienced a shorter ICU LOS (9.5 vs 16 days; P < .001) and hospital LOS (14.5 vs 22 days; P < .001) compared with the no-treatment group. Delirious patients who received pharmacological treatment within 24 hours of the first positive screen spent fewer days in physical restraints and less time receiving mechanical ventilation compared with those who did not. Although delirium management is multifactorial, early pharmacological therapy may benefit patients diagnosed with delirium.

  20. Effects of repeated restraint in Japanese quail genetically selected for contrasting adrenocortical responses.

    Science.gov (United States)

    Jones, R B; Satterlee, D G; Waddington, D; Cadd, G G

    2000-05-01

    Behavioral and adrenocortical responses to repeated mechanical restraint were compared in 28-day-old to 31-day-old male Japanese quail from two genetic lines divergently selected for reduced (low stress, LS) or exaggerated (high stress, HS) plasma corticosterone (C) responses to brief immobilization. Restraint in a metal crush cage for 5 min elicited immobility and silence in all the birds. Circulating C levels were considerably higher in quail of both lines following restraint than in the undisturbed controls of either line. As expected, both the behavioral and physiological effects were more pronounced in HS than in LS birds. Struggling increased with repeated restraint in HS and LS quail, thus suggesting behavioral habituation to the stressor in both lines. On the other hand, a line effect on the pattern of adrenocortical responses was revealed upon subtracting the change in plasma C concentrations from Day 1 to Day 4 in the undisturbed controls from the corresponding change in restrained birds. Thus, unlike LS quail, in which there were no detectable effects of repeated restraint, the adrenocortical responses of HS birds showed evidence of experience-dependent sensitization. Our results demonstrate the importance of the background genome in determining the patterns of the behavioral and adrenocortical responses elicited by repeated exposure to stressful stimulation. The present results and those of previous studies could be explained in one or both of two ways: that underlying fearfulness is lower in LS than HS quail or that they adopt active or passive coping strategies, respectively. Our findings may also have important implications for poultry welfare and productivity. @ 2000 Elsevier Science Inc.

  1. Greater physiological and behavioral effects of interrupted stress pattern compared to daily restraint stress in rats.

    Directory of Open Access Journals (Sweden)

    Wei Zhang

    Full Text Available Repeated stress can trigger a range of psychiatric disorders, including anxiety. The propensity to develop abnormal behaviors after repeated stress is related to the severity, frequency and number of stressors. However, the pattern of stress exposure may contribute to the impact of stress. In addition, the anxiogenic nature of repeated stress exposure can be moderated by the degree of coping that occurs, and can be reflected in homotypic habituation to the repeated stress. However, expectations are not clear when a pattern of stress presentation is utilized that diminishes habituation. The purpose of these experiments is to test whether interrupted stress exposure decreases homotypic habituation and leads to greater effects on anxiety-like behavior in adult male rats. We found that repeated interrupted restraint stress resulted in less overall homotypic habituation compared to repeated daily restraint stress. This was demonstrated by greater production of fecal boli and greater corticosterone response to restraint. Furthermore, interrupted restraint stress resulted in a lower body weight and greater adrenal gland weight than daily restraint stress, and greater anxiety-like behavior in the elevated plus maze. Control experiments demonstrated that these effects of the interrupted pattern could not be explained by differences in the total number of stress exposures, differences in the total number of days that the stress periods encompased, nor could it be explained as a result of only the stress exposures after an interruption from stress. These experiments demonstrate that the pattern of stress exposure is a significant determinant of the effects of repeated stress, and that interrupted stress exposure that decreases habituation can have larger effects than a greater number of daily stress exposures. Differences in the pattern of stress exposure are therefore an important factor to consider when predicting the severity of the effects of repeated

  2. Robust Foot Clearance Estimation Based on the Integration of Foot-Mounted IMU Acceleration Data

    Directory of Open Access Journals (Sweden)

    Mourad Benoussaad

    2015-12-01

    Full Text Available This paper introduces a method for the robust estimation of foot clearance during walking, using a single inertial measurement unit (IMU placed on the subject’s foot. The proposed solution is based on double integration and drift cancellation of foot acceleration signals. The method is insensitive to misalignment of IMU axes with respect to foot axes. Details are provided regarding calibration and signal processing procedures. Experimental validation was performed on 10 healthy subjects under three walking conditions: normal, fast and with obstacles. Foot clearance estimation results were compared to measurements from an optical motion capture system. The mean error between them is significantly less than 15 % under the various walking conditions.

  3. Factors associated with combined hand and foot eczema Associations between foot and hand eczema

    DEFF Research Database (Denmark)

    Agner, T; Aalto-Korte, K; Andersen, K E;

    2017-01-01

    BACKGROUND: As for hand eczema, the etiology of foot eczema is multifactorial, and not very well understood. The aim of the present study was to identify factors associated with foot eczema in a cohort of hand eczema patients being classified into different subgroups. METHODS: Associations between...... foot and hand eczema was studied in a cross sectional design in a cohort of hand eczema patients. Consecutive patients were recruited from 9 different European Centres during the period October 2011 - September 2012. Data on demographic factors, presence of foot eczema, hand eczema duration...... and severity, and whether the hand eczema was work-related or not were available, as well as patch-test results. RESULTS: Of a total of 427 hand eczema patients identified, information on foot eczema was available in 419 patients who were included in the present study. 125 patients (29.8 %) had concomitant...

  4. A shift in priority in diabetic foot care and research: 75% of foot ulcers are preventable.

    Science.gov (United States)

    Bus, Sicco A; van Netten, Jaap J

    2016-01-01

    Diabetic foot ulceration poses a heavy burden on the patient and the healthcare system, but prevention thereof receives little attention. For every euro spent on ulcer prevention, ten are spent on ulcer healing, and for every randomized controlled trial conducted on prevention, ten are conducted on healing. In this article, we argue that a shift in priorities is needed. For the prevention of a first foot ulcer, we need more insight into the effect of interventions and practices already applied globally in many settings. This requires systematic recording of interventions and outcomes, and well-designed randomized controlled trials that include analysis of cost-effectiveness. After healing of a foot ulcer, the risk of recurrence is high. For the prevention of a recurrent foot ulcer, home monitoring of foot temperature, pressure-relieving therapeutic footwear, and certain surgical interventions prove to be effective. The median effect size found in a total of 23 studies on these interventions is large, over 60%, and further increases when patients are adherent to treatment. These interventions should be investigated for efficacy as a state-of-the-art integrated foot care approach, where attempts are made to assure treatment adherence. Effect sizes of 75-80% may be expected. If such state-of-the-art integrated foot care is implemented, the majority of problems with foot ulcer recurrence in diabetes can be resolved. It is therefore time to act and to set a new target in diabetic foot care. This target is to reduce foot ulcer incidence with at least 75%.

  5. Nursing care of the aging foot.

    Science.gov (United States)

    Mitty, Ethel

    2009-01-01

    Feet are not necessarily the most attractive part of the body as it ages, and given the choice, most older adults would rather ignore them. In fact, many older adults cannot even see them, reach them, or care for them properly. And when they ache or look misshapen and oddly colored; well, that's just part of growing old, isn't it? The feet are important for weight bearing, balance, and mobility. Over an average life span, the feet are subject to considerable stress and trauma. Age-related changes of the foot predispose the older adult to discomfort if not pain, fungal infection, reduced range of motion, and itchy dry skin. More than three fourths of older adults (i.e., those age over 65 years) complain of foot pain that is associated with a significant foot problem and have evidence of arthritic changes on x-ray. Impaired ambulation can make the difference between independence versus dependency on others, engagement versus isolation. Assisted living is about choices. Being unable to get where one wants to go or do what one wants to do because of foot problems is a barrier to full enjoyment of the opportunities in assisted living communities. This article describes foot problems associated with aging, diabetes, nursing assessment of the feet, and nursing interventions in the service of accessing and optimizing choices for quality of life.

  6. 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

    Full Text Available Abstract Background To date, the literature has provided an abundance of evidence on the adverse outcomes of restraint use on patients. Reportedly, nurses are often the personnel who initiate restraint use and attribute its use to ensuring the safety of the restrained and the others. A clinical trial using staff education and administrative input as the key components of a restraint reduction program was conducted in a rehabilitation setting to examine whether there were any significant differences in the prevalence of restraint use pre- and post-intervention. Subsequent to the implementation of the intervention program, focus group interviews were conducted to determine the perspective of the nursing staff on the use of restraints and their opinions of appropriate means to reduce their use. Method Registered nurses working in units involved in the study were invited to participate in focus group interviews on a voluntary basis. Twenty-two registered nurses (three males [13.6%] and nineteen females [86.4%] attended the four sessions. All interviews were audio taped and transcribed verbatim. Other than the author, another member of the project team validated the findings from the data analysis. Results Four themes were identified. Participants experienced internal conflicts when applying physical restraints and were ambivalent about their use, but they would use restraints nonetheless, mainly to prevent falls and injuries to patients. They felt that nurse staffing was inadequate and that they were doing the best they could. They experienced pressure from the management level and would have liked better support. Communication among the various stakeholders was a problem. Each party may have a different notion about what constitutes a restraint and how it can be safely used, adding further weight to the burden shouldered by staff. Conclusion Studies about restraints and restraint use have mostly focused on nurses' inadequate and often inaccurate

  7. The effect of head restraints and seat belts on the incidence of neck injury in car accidents.

    Science.gov (United States)

    Olney, D B; Marsden, A K

    1986-11-01

    During a 5-month period a study was made of motor vehicle occupants presenting at an Accident and Emergency department following an accident. Records were made of the incidence of neck injuries in relation to the presence of head restraints and the use of seat belts. There was a slight reduction in injuries when a head restraint was fitted but this difference did not achieve statistical significance. The incidence of neck injury was not increased if a seat belt was worn. It may be that the reason for the failure of head restraints to afford the expected protection is their inappropriate design and lack of adequate adjustability.

  8. Clinical management of acute diabetic Charcot foot in Denmark

    DEFF Research Database (Denmark)

    Jansen, Rasmus Bo; Svendsen, Ole Lander; Kirketerp-Møller, Klaus

    2016-01-01

    INTRODUCTION: Charcot foot is a severe complication to diabetes mellitus and treatment involves several different clinical specialities. Our objective was to describe the current awareness, knowledge and treatment practices of Charcot foot among doctors who handle diabetic foot disorders. METHODS...... and treatment practices of acute diabetic Charcot foot at diabetes foot clinics in Denmark. The responders seem to follow the international recommendations and guidelines on management of the acute diabetic Charcot foot, despite a lack of Danish guidelines. FUNDING: none. TRIAL REGISTRATION: not relevant....

  9. Outpatient assessment and management of the diabetic foot.

    Science.gov (United States)

    DiPreta, John A

    2014-03-01

    Patients with diabetes and peripheral neuropathy are at risk for foot deformities and mechanical imbalance of the lower extremity. Peripheral neuropathy leads to an insensate foot that puts the patient at risk for injury. When combined with deformity due to neuropathic arthropathy, or Charcot foot, the risks of impending ulceration, infection, and amputation are significant to the diabetic patient. Education of proper foot care and shoe wear cannot be overemphasized. For those with significant malalignment or deformity of the foot and ankle, referral should be made immediately to an orthopedic foot and ankle specialist.

  10. Effect of Custom-Molded Foot Orthoses on Foot Pain and Balance in Children With Symptomatic Flexible Flat Feet

    Science.gov (United States)

    Lee, Hong-Jae; Lim, Kil-Byung; Yoo, JeeHyun; Yun, Hyun-Ju; Jeong, Tae-Ho

    2015-01-01

    Objective To evaluate the effect of custom-molded foot orthoses on foot pain and balance in children with symptomatic flexible flat foot 1 month and 3 months after fitting foot orthosis. Method A total of 24 children over 6 years old with flexible flat feet and foot pain for at least 6 months were recruited for this study. Their resting calcaneal stance position and calcaneal pitch angle were measured. Individual custom-molded rigid foot orthoses were prescribed using inverted orthotic technique to control foot overpronation. Pain questionnaire was used to obtain pain sites, degree, and frequency. Balancing ability was determined using computerized posturography. These evaluations were performed prior to custom-molded foot orthoses, 1 month, and 3 months after fitting foot orthoses. Result Of 24 children with symptomatic flexible flat feet recruited for this study, 20 completed the study. Significant (p<0.001) improvements in pain degree and frequency were noted after 1 and 3 months of custom-molded foot orthoses. In addition, significant (p<0.05) improvement in balancing ability was found after 3 months of custom-molded foot orthoses. Conclusion Short-term use of custom-molded foot orthoses significantly improved foot pain and balancing ability in children with symptomatic flexible flat foot. PMID:26798604

  11. Knowledge, perceptions, and experiences of family caregivers and home care providers of physical restraint use with home-dwelling elders: a cross-sectional study in Japan.

    Science.gov (United States)

    Kurata, Sadami; Ojima, Toshiyuki

    2014-03-27

    The use of physical restraints by family caregivers with home-dwelling elders has not been extensively studied but it might be widespread. Furthermore, it is also not clear how home care providers who support family caregivers perceive the use of physical restraint in elders' homes. This study assessed family caregivers' and home care providers' knowledge and perceptions of physical restraint used with elders living at home in Japan, a country with the highest proportion of elders in the world and where family caregiving is common. We undertook a cross-sectional study of 494 family caregivers, 201 home helpers, 78 visiting nurses, 131 visiting physicians, and 158 care managers of home-dwelling frail elders needing some care and medical support in Japan, using questionnaires on knowledge of 11 physical restraint procedures prohibited in institutions and 10 harmful effects of physical restraints, perceptions of 17 reasons for requiring physical restraints, and experiences involving physical restraint use. Family caregivers were aware of significantly fewer recognized prohibited physical restraint procedures and recognized harmful effects of physical restraint than home care providers, and differences among home care providers were significant. The average importance rating from 1 (least) to 5 (most) of the 17 reasons for requiring physical restraints was significantly higher among family caregivers than home care providers, and significantly different among the home care providers. Moreover, these differences depended in part on participation in physical restraint education classes. While 20.1% of family caregivers had wavered over using physical restraints, 40.5% of home care providers had seen physical restraints used in elders' homes and 16.7% had advised physical restraint use or used physical restraints themselves. Knowledge and perceptions of physical restraints differed between family caregivers and home care providers and were also diverse among home care

  12. [Mycetoma of the foot: a case report].

    Science.gov (United States)

    Iniesta, A; Baptista, C; Guinard, D; Legré, R; Gay, A

    2015-04-01

    Mycetoma is a chronic inflammatory cutaneous and subcutaneous pathology caused by either a fongic (eumycetoma) or bacterial (actinomycetoma) infection, which lead to a granulomatous tumefaction with multiple sinuses. When localized in the foot this infection is named "Madura foot". This infection is endemic to tropical and subtropical regions and rarely occurs in western countries. A historical case in Europe of a foot mycetoma evolving since 20 years without any treatment is presented. A histopathologic diagnosis of actinomycetoma has been done in 1987. The patient presented a severe Staphylococcus aureus chronic osteitis leading to a trans-tibial amputation. This case allows to present this infection which, even if rarely presented in France, can be meet especially among a migrant's population.

  13. Macrodystrophia lipomatosa of foot involving great toe.

    Science.gov (United States)

    Gaur, A K; Mhambre, A S; Popalwar, H; Sharma, R

    2014-06-01

    Macrodystrophia lipomatosa is a rare form of congenital disorder in which there is localized gigantism characterized by progressive overgrowth of all mesenchymal elements with a disproportionate increase in the fibroadipose tissues. The adipose tissue infiltration involves subcutaneous tissue, periosteum, nerves and bone marrow. Most of the cases reported have hand or foot involvement. Patient seeks medical help for improving cosmesis or to get the size of the involved part reduced in order to reduce mechanical problems. We report a case of macrodystrophia lipomatosa involving medial side of foot with significant enlargement of great toe causing concern for cosmesis and inconvenience due to mechanical problems. The X-rays showed increased soft tissue with more of adipose tissue and increased size of involved digits with widening of ends. Since the patient's mother did not want any surgical intervention he was educated about foot care and proper footwear design was suggested.

  14. [Spanish adaptation and validation of the Perception of Restraint Use Questionnaire (PRUQ) on the use of physical restraints on the elderly].

    Science.gov (United States)

    Fariña López, E; Estévez-Guerra, G J; Núñez González, E; Calvo Francés, F; Penelo, E

    2016-04-29

    To adapt and to validate in a Spanish population the Perception of Restraint Use Questionnaire (PRUQ), which assesses the importance that professionals give to the use of physical restraints when caring for older adults. After a process of forward-back translation and linguistic adaptation, a Spanish version of the original questionnaire was obtained. A descriptive cross-sectional multicenter study was then carried out. Based on non-probability sampling, 20 centers from three Spanish regions were selected; 830 professionals agreed to participate. 15 of the 17 items of the original questionnaire were translated literally and two required minor modifications.All were considered acceptable by an expert panel(content validity index of 0.89); a pilot study confirmed the adequate feasibility of the questionnaire. The principal components analysis identified three dimensions that explained 66.2% of variance. The confirmatory factor analysis of this tridimensional model showed an acceptable fit [CFI = 0.936; RMSEA = 0.080], being factor loadings and factor correlations statistically significant (p<0.001). The internal consistency (Cronbach's alpha) for the total score was 0.92 and the test-retest reliability (ICCa) was 0.87 (95%CI: 0.78 to 0.92) over an interval of three weeks. The Spanish version of the PRUQ shows good psychometric characteristics and is adapted to the cultural context of this country. It may be considered a useful tool to assess in which situations professionals consider the use of physical restraints most necessary, helping to design training activities aimed at rationalizing its application.

  15. Chinese Herbal Foot Bath plus Acupoint Massage Beneficial to the Improvement of Grade 0 Diabetic Foot

    Institute of Scientific and Technical Information of China (English)

    Lin Xiao-xia; Xu Xu-yuan; Shangguan Bin-bin

    2014-01-01

    Objective: To observe the clinical effect of foot bath with Tao Hong Si Wu Tang plus massage on acupoints at the sole for grade 0 diabetic foot. Methods: One hundred and sixty eligible cases were randomly divided into an observation group and a control group, 80 cases in each group. The two groups were treated with routine basic medications to control blood sugar. The patients in the observation group were given foot bath withTao Hong Si Wu Tangplus massage on acupoints at the sole, once every day. At the same time, the patients were instructed to understand the knowledge of diabetes, accept the education on foot care and to know the self-management for diabetes. The patients in the control group only accepted the education on foot care and studied the self-management for diabetes. The patients in the two groups were followed up once every week by phone. The local examination was intensified for the patients in their clinical visit every month. The therapeutic effects were assessed after three months of continuous treatment. Results: The total effective rate was 92.5% in the observation group, remarkably higher than 65.0% in the control group. The difference in comparison of the general therapeutic effect was statistically significant (P Conclusion: Foot bath withTao Hong Si Wu Tang plus massage on acupoints at the sole was beneficial to the improvement of clinical symptoms of grade 0 diabetic foot.

  16. Belt restraint reduction in nursing homes: design of a quasi-experimental study

    Directory of Open Access Journals (Sweden)

    van Rossum Erik

    2010-02-01

    Full Text Available Abstract Background The use of physical restraints still is common practice in the nursing home care. Since physical restraints have been shown to be an ineffective and sometimes even hazardous measure, interventions are needed to reduce their usage. Several attempts have been made to reduce the use of physical restraints. Most studies used educational approaches and introduced a nurse specialist as a consultant. However, the success rate of these interventions has been inconsistent. We developed a new multi-component intervention (EXBELT comprising an educational intervention for nursing home staff in combination with a policy change (belt use is prohibited by the nursing home management, availability of a nurse specialist and nursing home manager as consultants, and availability of alternative interventions. The first aim of this study is to further develop and test the effectiveness of EXBELT on belt restraint reduction in Dutch psychogeriatric nursing homes. However, the reduction of belts should not result in an increase of other restrictive restraints (such as a chair with locked tray table or psychoactive drug use. The overall aim is an effective and feasible intervention that can be employed on a large scale in Dutch nursing homes. Methods and design Effects of EXBELT will be studied in a quasi-experimental longitudinal study design. Alongside the effect evaluation, a process evaluation will be carried out in order to further develop EXBELT. Data regarding age, gender, use of physical restraints, the number of falls and fall related injuries, psychoactive drug use, and the use of alternative interventions will be collected at baseline and after four and eight months of follow-up. Data regarding the process evaluation will be gathered in a period of eight months between baseline and the last measurement. Furthermore, changing attitudes will become an important addition to the educational part of EXBELT. Discussion A quasi

  17. Foot and Ankle Injuries in American Football.

    Science.gov (United States)

    Hsu, Andrew R; Anderson, Robert B

    Physicians need to be aware of a variety of foot and ankle injuries that commonly occur in American football, including turf toe, Jones fractures, Lisfranc injuries, syndesmotic and deltoid disruption, and Achilles ruptures. These injuries are often complex and require early individual tailoring of treatment and rehabilitation protocols. Successful management and return to play requires early diagnosis, a thorough work-up, and prompt surgical intervention when warranted with meticulous attention to restoration of normal foot and ankle anatomy. Physicians should have a high suspicion for subtle injuries and variants that can occur via both contact and noncontact mechanisms.

  18. Diabetic foot ulcers: Part II. Management.

    Science.gov (United States)

    Alavi, Afsaneh; Sibbald, R Gary; Mayer, Dieter; Goodman, Laurie; Botros, Mariam; Armstrong, David G; Woo, Kevin; Boeni, Thomas; Ayello, Elizabeth A; Kirsner, Robert S

    2014-01-01

    The management of diabetic foot ulcers can be optimized by using an interdisciplinary team approach addressing the correctable risk factors (ie, poor vascular supply, infection control and treatment, and plantar pressure redistribution) along with optimizing local wound care. Dermatologists can initiate diabetic foot care. The first step is recognizing that a loss of skin integrity (ie, a callus, blister, or ulcer) considerably increases the risk of preventable amputations. A holistic approach to wound assessment is required. Early detection and effective management of these ulcers can reduce complications, including preventable amputations and possible mortality.

  19. Foot and ankle injuries in theatrical dancers.

    Science.gov (United States)

    Hardaker, W T; Margello, S; Goldner, J L

    1985-10-01

    The theatrical dancer is a unique combination of athlete and artist. The physical demands of dance class, rehearsal, and performance can lead to injury, particularly to the foot and ankle. Ankle sprains are the most common acute injury. Chronic injuries predominate and relate primarily to the repeated impact loading of the foot and ankle on the dance floor. Contributing factors include anatomic variation, improper technique, and fatigue. Early and aggressive conservative management is usually successful and surgery is rarely indicated. Orthotics play a limited but potentially useful role in treatment. Following treatment, a structured rehabilitation program is fundamental to the successful return to dance.

  20. Forensic mental health clinician's experiences with and assessment of alliance regarding the patient's readiness to be released from mechanical restraint

    DEFF Research Database (Denmark)

    Nielsen, Lea Deichmann; Gildberg, Frederik Alkier; Bech, Per

    2017-01-01

    One of the main reasons for prolonged duration of mechanical restraint is patient behaviour in relation to the clinician-patient alliance. This article reports on the forensic mental health clinicians experiences of the clinician-patient alliance during mechanical restraint, and their assessment...... of parameters of alliance regarding the patient's readiness to be released from restraint. We used a qualitative, descriptive approach and conducted focus group interviews with nurses, nurse assistants and social and healthcare assistants. The results show that a pre-established personal clinician......-patient alliance formed the basis for entering into, and weighing the quality of, the alliance during mechanical restraint. In consideration of the patient's psychiatric condition, the clinicians observed and assessed two quality parameters for the alliance: 'the patient's insight into or understanding of present...

  1. Interactive effects of dietary restraint and adiposity on stress-induced eating and the food choice of children

    Science.gov (United States)

    The Individual Differences Model posits that individual differences in physiological and psychological factors explain eating behaviors in response to stress. The purpose was to determine the effects of individual differences in adiposity, dietary restraint and stress reactivity on children's energy...

  2. Diabetic foot ulcers: Part I. Pathophysiology and prevention.

    Science.gov (United States)

    Alavi, Afsaneh; Sibbald, R Gary; Mayer, Dieter; Goodman, Laurie; Botros, Mariam; Armstrong, David G; Woo, Kevin; Boeni, Thomas; Ayello, Elizabeth A; Kirsner, Robert S

    2014-01-01

    Diabetes mellitus is a serious, life-long condition that is the sixth leading cause of death in North America. Dermatologists frequently encounter patients with diabetes mellitus. Up to 25% of patients with diabetes mellitus will develop diabetic foot ulcers. Foot ulcer patients have an increased risk of amputation and increased mortality rate. The high-risk diabetic foot can be identified with a simplified screening, and subsequent foot ulcers can be prevented. Early recognition of the high-risk foot and timely treatment will save legs and improve patients' quality of life. Peripheral arterial disease, neuropathy, deformity, previous amputation, and infection are the main factors contributing to the development of diabetic foot ulcers. Early recognition of the high-risk foot is imperative to decrease the rates of mortality and morbidity. An interprofessional approach (ie, physicians, nurses, and foot care specialists) is often needed to support patients' needs.

  3. Comorbidities associated with Egyptian diabetic foot disease subtypes

    Directory of Open Access Journals (Sweden)

    Mary N. Rizk

    2013-01-01

    Conclusion Special attention should be paid toward the identification of patients who are at risk of foot ulceration to help prevent foot problems. Comorbid conditions must also be identified early and managed aggressively.

  4. A Descriptive Study Of Foot Complications In Diabetic Patients With ...

    African Journals Online (AJOL)

    Symptomatic peripheral neuropathy in a diabetic patient may be associated with the ... skin and fungal infections were the most frequent lesions seen in diabetic ... Foot complications other than foot ulcers may occur in diabetic patients with ...

  5. Educational intervention on physical restraint use in long-term care facilities - Systematic review and meta-analysis.

    Science.gov (United States)

    Lan, Shao-Huan; Lu, Li-Chin; Lan, Shou-Jen; Chen, Jong-Chen; Wu, Wen-Jun; Chang, Shen-Peng; Lin, Long-Yau

    2017-08-01

    "Physical restraint" formerly used as a measure of protection for psychiatric patients is now widely used. However, existing studies showed that physical restraint not only has inadequate effect of protection but also has negative effects on residents. To analyzes the impact of educational program on the physical restraint use in long-term care facilities. A systematic review with meta-analysis and meta-regression. Eight databases, including Cochrane Library, ProQuest, PubMed, EMBASE, EBSCO, Web of Science, Ovid Medline and Physiotherapy Evidence Database (PEDro), were searched up to January 2017. Eligible studies were classified by intervention and accessed for quality using the Quality Assessment Tool for quantitative studies. Sixteen research articles were eligible in the final review; 10 randomize control trail studies were included in the analysis. The meta-analysis revealed that the use of physical restraint was significantly less often in the experimental (education) group (OR = 0.55, 95% CI: 0.39 to 0.78, p < 0.001) compared to the control group. Meta-regression revealed the period of post education would have decreased the effect of the restraint educational program (β: 0.08, p = 0.002); instead, the longer education period and more times of education would have a stronger effect of reducing the use of physical restraint (β: -0.07, p < 0.001; β: -0.04, p = 0.056). The educational program had an effect on the reduced use of physical restraint. The results of meta-regression suggest that long-term care facilities should provide a continuous education program of physical restraint for caregivers. Copyright © 2017. Published by Elsevier Taiwan.

  6. The Validity of the Doctrine of Restraint of Trade Under the Nigerian Labour Law

    Directory of Open Access Journals (Sweden)

    Uko, E. J.

    2013-08-01

    Full Text Available The doctrine of restraint of trade presents itself as a double-edged sword that can both do and undo. While it seeks to prevent abuse in regards to certain trade practices on the one hand, it tends to proffer excessive abuse and violations of the individuals’ rights to certain trade freedoms, if wrongly and widely applied, on the other hand. This article explores the various dimensions that cut across diverse boundaries touching human rights, ethics, equity, trade customs and other considerations. In as much as the doctrine of restraint of trade has come to stay, the courts as final arbiters have ensured that there be standards and guides, and this helped them to, in any given case, decide whether such agreement is valid or not. In conclusion, therefore, this work notes that there should be a legal framework, that will reduce likely and imaginary situations and circumstances that may give rise to litigations in black and white.

  7. Physical restraint in acute care psychiatry: a humanistic and realistic nursing approach.

    Science.gov (United States)

    Moylan, Lois Biggin

    2009-03-01

    Despite the many advances in psychiatry, violence in acute care settings continues and may be increasing. This is particularly problematic, considering the desire of mental health professionals to attain the goal of a restraint-free environment. Respecting the inherent worth, dignity, and autonomy of the patient is necessary if a therapeutic outcome is to be achieved; however, protecting the safety of the patient, other patients, and the caregivers is of no less importance, yet this responsibility also carries with it legal and ethical implications. Balancing these two responsibilities can be realized even in a situation where supportive therapeutic interventions have been ineffective in de-escalation of an aggressive patient. When used with a compassionate, humanistic approach, restraint can achieve a therapeutic outcome for the patient while protecting the safety of others.

  8. 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.

  9. Assessment of molecular structure using frame-independent orientational restraints derived from residual dipolar couplings

    Energy Technology Data Exchange (ETDEWEB)

    Skrynnikov, Nikolai R.; Kay, Lewis E. [University of Toronto, Protein Engineering Network Centers of Excellence and Departments of Medical Genetics, Biochemistry and Chemistry (Canada)

    2000-11-15

    Residual dipolar couplings measured in weakly aligning liquid-crystalline solvent contain valuable information on the structure of biomolecules in solution. Here we demonstrate that dipolar couplings (DCs) can be used to derive a comprehensive set of pairwise angular restraints that do not depend on the orientation of the alignment tensor principal axes. These restraints can be used to assess the agreement between a trial protein structure and a set of experimental dipolar couplings by means of a graphic representation termed a 'DC consistency map'. Importantly, these maps can be used to recognize structural elements consistent with the experimental DC data and to identify structural parameters that require further refinement, which could prove important for the success of DC-based structure calculations. This approach is illustrated for the 42 kDa maltodextrin-binding protein.

  10. Traumatic foot injuries in horses: surgical management.

    Science.gov (United States)

    Burba, Daniel J

    2013-01-01

    Managing traumatic foot wounds in horses may require surgical intervention. These wounds include coronary-band and heel-bulb lacerations, septic pedal osteitis, septic navicular bursitis, sepsis of the collateral cartilages, and hoof-wall injuries. This article provides a practical overview of the surgical management of these types of wounds.

  11. Foot-and-mouth disease vaccines

    Science.gov (United States)

    Foot-and-mouth disease (FMD) is a highly contagious disease of domestic and wild cloven-hoofed animals. This disease has affected most areas of the world, often causing extensive epizootics in livestock, mostly farmed cattle and swine, although sheep, goats and many wild species are also susceptible...

  12. Assessment of acute foot and ankle sprains.

    Science.gov (United States)

    Lynam, Louise

    2006-07-01

    Acute ankle and foot trauma is a regular emergency presentation and prompt strategic assessment skills are required to enable nurses to categorise and prioritise these injuries appropriately. This article provides background information on the anatomy and physiology of the lower limb to help nurses to identify various grades of ankle sprain as well as injuries that are limb threatening

  13. Diabetic foot complications: diagnosis and management.

    Science.gov (United States)

    Giurini, John M; Lyons, Thomas E

    2005-09-01

    Foot complications in patients with diabetes mellitus are a challenge to the health care industry. A great deal of expenditure is due to the management of diabetic foot complications. This places a great burden on the health care industry. It also places a great burden on those diabetic patients with foot complications and their families. Therefore, their effective management in an efficient manner is crucial to our patients. To deal with these problems, a dedicated, knowledgeable, and experienced multidisciplinary team is key. Intervention at the earliest possible time yields the best outcome. Prevention is the focus for those with no ulcerations. For those with ulcerations, prompt recognition and treatment is key. The importance of classifying ulcerations according to size, depth, presence or absence of infection, and vascular status can not be overstated. Proper offloading is vital for those with neuropathic lesions. Recognition of patients with a component of ischemia and vascular intervention to increase perfusion will aid in wound healing. Of course deep infection requires immediate drainage. All efforts of those in the multidisciplinary team are directed at the restoration and maintenance of an ulcer-free foot which is important in enabling our patients to maintain their ambulatory status.

  14. ESTIMATION OF STATURE BASED ON FOOT LENGTH

    Directory of Open Access Journals (Sweden)

    Vidyullatha Shetty

    2015-01-01

    Full Text Available BACKGROUND : Stature is the height of the person in the upright posture. It is an important measure of physical identity. Estimation of body height from its segments or dismember parts has important considerations for identifications of living or dead human body or remains recovered from disasters or other similar conditions. OBJECTIVE : Stature is an important indicator for identification. There are numerous means to establish stature and their significance lies in the simplicity of measurement, applicability and accuracy in prediction. Our aim of the study was to review the relationship between foot length and body height. METHODS : The present study reviews various prospective studies which were done to estimate the stature. All the measurements were taken by using standard measuring devices and standard anthropometric techniques. RESULTS : This review shows there is a correlation between stature and foot dimensions it is found to be positive and statistically highly significant. Prediction of stature was found to be most accurate by multiple regression analysis. CONCLUSIONS : Stature and gender estimation can be done by using foot measurements and stud y will help in medico - legal cases in establishing identity of an individual and this would be useful for Anatomists and Anthropologists to calculate stature based on foot length

  15. Complex interventions for preventing diabetic foot ulceration

    NARCIS (Netherlands)

    Hoogeveen, Ruben C; Dorresteijn, Johannes A N; Kriegsman, Didi M W; Valk, Gerlof D.

    2015-01-01

    BACKGROUND: Ulceration of the feet, which can lead to the amputation of feet and legs, is a major problem for people with diabetes mellitus, and can cause substantial economic burden. Single preventive strategies have not been shown to reduce the incidence of foot ulceration to a significant extent.

  16. Do foot pad scores measure Turkey welfare

    NARCIS (Netherlands)

    Hocking, P.M.; Harkness, A.; Veldkamp, Teun; Vinco, L.J.

    2017-01-01

    The main aim of the project was to assess the painfulness of different levels of foot pad dermatitis (FPD) in turkeys. Three different analgesics (butorphanol, carprofen and meloxicam) were used to assess their effect on behaviour. Video recordings were taken when the birds were treated with either

  17. Influence of footings stiffness on punching resistance

    Directory of Open Access Journals (Sweden)

    Ĺudovít Fillo

    2016-03-01

    Full Text Available The presented paper brings new aspects of punching resistance due to influence of footing stiffness and consequential ground stresses distribution. Diagrams of design load versus effective depth were created coming from new design criteria which depend on the maximum punching resistance defined from shear-bending failure and on the maximum punching resistance defined from crushing of concrete struts.

  18. Osteoarthritis of the Foot and Ankle

    Science.gov (United States)

    ... that creates an increased risk of arthritis. Symptoms People with osteoarthritis in the foot or ankle experience, in varying degrees, one or more of the following: Pain and stiffness in the joint Swelling in or near the joint Difficulty walking or bending the joint Some patients with osteoarthritis ...

  19. [Neuropad test in evaluation of diabetic foot].

    Science.gov (United States)

    Vieru, Alexandra; Niţă, Otilia; Graur, Lidia Iuliana; Mazilu, Georgiana; Mihalache, Laura; Popescu, Raluca Maria; Graur, Mariana

    2012-01-01

    Diabetic neuropathy (DN) is the main cause of foot ulceration. One of the earliest modifications is the loss of normal sudomotor function, a sign of autonomic neuropathy. The aim of this study is to evaluate sudomotor dysfunction using a new tool (Neuropad) in diabetic patients with foot ulceration. We included 58 diabetic patients with foot ulceration admitted in 2010 in the Clinical Center for Diabetes, Nutrition and Metabolic Diseases. We collected data regarding age, gender, type and duration of diabetes, glycated hemoglobin (HbAlc), history of amputations and duration of hospital admission. Peripheral neuropathy was evaluated through the Neuropathy Disability Score (NDS) and autonomic neuropathy was tested through Neuropad. 95% of patients had NDS > or = 6, among which 76% had also positive Neuropad test. Patients with both peripheral and autonomic neuropathy had longer duration of diabetes (p = 0.027) but similar HbA1c as patients with only peripheral neuropathy (p = 0.09). The former also had longer duration of current admission (p = 0.022) and a higher percentage of these patients had history of amputations (p = 0.041). Neuropad is a reliable, easy to use test for the diagnosis of autonomic neuropathy, which puts patients at greater risk for foot ulceration and amputation.

  20. ATA gas propagation - 1 foot tank experiment

    Energy Technology Data Exchange (ETDEWEB)

    Chong, Y.P.; Caporaso, G.J.; Chambers, F.W.; Fawley, W.M.; Lauer, E.J.; Paul, A.C.; Prono, D.S.; Weir, J.T.

    1984-06-27

    The first gas propagation experiment on ATA is planned to be conducted in a 1-foot diameter tank of up to 10 m length. The primary objectives are to measure beam parameters at injection to determine whether the desired beam conditioning is achieved, and to observe how such conditioned beams propagate in air and neon.

  1. Complex interventions for preventing diabetic foot ulceration

    NARCIS (Netherlands)

    Hoogeveen, Ruben C; Dorresteijn, Johannes A N; Kriegsman, Didi M W; Valk, Gerlof D.

    2015-01-01

    BACKGROUND: Ulceration of the feet, which can lead to the amputation of feet and legs, is a major problem for people with diabetes mellitus, and can cause substantial economic burden. Single preventive strategies have not been shown to reduce the incidence of foot ulceration to a significant extent.

  2. Pixel classification for automated diabetic foot diagnosis

    NARCIS (Netherlands)

    Kloeze, C.; Klein, A.; Hazenberg, S.; Heijden, van der F.; Baal, van J.G.; Bus, S.A.

    2009-01-01

    Worldwide, more than 180 million people suffer from diabetes mellitus. Approximately 50% of these patients will develop complications to their feet. Neuropathy, combined with poor blood supply and biomechanical changes results in a high risk for foot ulcers, which is a key problem in the diabetic fo

  3. Malignant melanoma of the foot and ankle.

    Science.gov (United States)

    John, K J; Hayes, D W; Green, D R; Dickerson, J

    2000-04-01

    Malignant melanoma is a serious and devastating skin disease that podiatrists may be called upon to treat. It is pertinent that delays in diagnosis and treatment of malignant melanoma be avoided. Some of the topics discussed in this article are causes, clinical features, classification, and treatment of malignant melanoma, focusing on the foot and ankle.

  4. Stigma and Management on People with Severe Mental Disorders with “Pasung” (Physical restraint

    Directory of Open Access Journals (Sweden)

    Weny Lestari

    2015-01-01

    Full Text Available background: Mental disorders remain serious mental health problems in Indonesia. In 2007 there were 0,46 percent of the total population in Indonesia had high risk of schizophrenia. There are many people with severe mental disorders who do not receive medical treatment or dropped out from medical treatment and then put in physical restraint. Methods:The analysis was based on previous study on the elimination program for physical restraints in 2011. The methods were by collecting news, research results and reviews about stigma and management on people with severe mental disorders. results showed that suspect mental disorders people who had physical restraints by their families was the last alternative of mental disorders management after all medical treatment seek by the families. But the families and communities unknowing early detection and post-treatment management at the Mental Health Hospital causes the patient did not treated properly. People with mental disorders frequently also stigmatized on their neighbourhood. The stigma attached to the patient them selves and their families. Health and socio-cultural’s consequences of stigma in people with mental disorders were as not treated optimally, dropout from the treatment, had physical restraint and incorrect understanding about people with mental disorders. conclutions:The conclusions are that it needs to socialize about early detection of mental disorders sympton to community to prevent delays on early phase treatment that could be cured. Besides empowering people is needed to improve knowledge about mental disorders and emotional disturbance at certain levels in order to avoid the stigma against people with mental disorders.

  5. Negative Modulation of NO for Diaphragmatic Contractile Reduction Induced by Sepsis and Restraint Position

    Institute of Scientific and Technical Information of China (English)

    XIANG Jian; GUAN Su-dong; SONG Xiang-he; WANG Hui-yun; GU Zhen-yong

    2014-01-01

    In practice of forensic medicine, potential disease can be associated with fatal asphyxia in re-straint position. Research has demonstrated that nitric oxide (NO) and nitric oxide synthase (NOS) are plentifully distributed in skeletal muscle, contributing to the regulation of contractile and relaxation. In the current study, respiratory functions, indices of diaphragmatic biomechanical functions ex vivo, as well as NO levels in serum, the expressions of diaphragmatic inducible NOS (iNOS) mRNA, and the effects of L-NNA on contractility of the diaphragm were observed in sepsis induced by cecal ligation and punc-ture (CLP) under the condition of restraint position. The results showed that in the CLP12-18 h rats, respiratory dysfunctions; indices of diaphragmatic biomechanical functions (Pt, +dT/dtmax, -dT/dtmax, CT, Po, force over the full range of the force-frequency relationship and fatigue resistance ) declined progressive-ly; the NO level in serum, and iNOS mRNA expression in the diaphragm increased progressively; force increased significantly at all stimulation frequencies after L-NNA pre-incubation. Restraint position 1 h in CLP12 h rats resulted in severe respiratory dysfunctions after relative stable respiratory functions, almost all the indices of diaphragmatic biomechanical functions declined further, whereas little change took place in NO level in serum and diaphragmatic iNOS mRNA expression; and the effects of L-NNA were lack of statistical significance compared with those of CLP12 h, but differed from CLP18 h group. These results suggest that restraint position and sepsis act together in a synergistic manner to aggravate the great reduction of diaphragmatic contractility via, at least in part, the negative modulation of NO, which may contribute to the pathogenesis of positional asphyxia.

  6. Housing in Pyramid Counteracts Neuroendocrine and Oxidative Stress Caused by Chronic Restraint in Rats

    Directory of Open Access Journals (Sweden)

    M. Surekha Bhat

    2007-01-01

    Full Text Available The space within the great pyramid and its smaller replicas is believed to have an antistress effect. Research has shown that the energy field within the pyramid can protect the hippocampal neurons of mice from stress-induced atrophy and also reduce neuroendocrine stress, oxidative stress and increase antioxidant defence in rats. In this study, we have, for the first time, attempted to study the antistress effects of pyramid exposure on the status of cortisol level, oxidative damage and antioxidant status in rats during chronic restraint stress. Adult female Wistar rats were divided into four groups as follows: normal controls (NC housed in home cage and left in the laboratory; restrained rats (with three subgroups subject to chronic restraint stress by placing in a wire mesh restrainer for 6 h per day for 14 days, the restrained controls (RC having their restrainers kept in the laboratory; restrained pyramid rats (RP being kept in the pyramid; and restrained square box rats (RS in the square box during the period of restraint stress everyday. Erythrocyte malondialdehyde (MDA and plasma cortisol levels were significantly increased and erythrocyte-reduced glutathione (GSH levels, erythrocyte glutathione peroxidase (GSH-Px and superoxide dismutase (SOD activities were significantly decreased in RC and RS rats as compared to NC. However, these parameters were maintained to near normal levels in RP rats which showed significantly decreased erythrocyte MDA and plasma cortisol and significantly increased erythrocyte GSH levels, erythrocyte GSH-Px and SOD activities when compared with RS rats. The results showed that housing in pyramid counteracts neuroendocrine and oxidative stress caused by chronic restraint in rats.

  7. The capsular ligaments provide more hip rotational restraint than the acetabular labrum and the ligamentum teres

    OpenAIRE

    2015-01-01

    In this in vitro study of the hip joint we examined which soft tissues act as primary and secondary passive rotational restraints when the hip joint is functionally loaded. A total of nine cadaveric left hips were mounted in a testing rig that allowed the application of forces, torques and rotations in all six degrees of freedom. The hip was rotated throughout a complete range of movement (ROM) and the contributions of the iliofemoral (medial and lateral arms), pubofemoral and ischiofemoral l...

  8. 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.

  9. 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.

  10. Influence of omega-3 fatty acid status on the way rats adapt to chronic restraint stress.

    Directory of Open Access Journals (Sweden)

    Marie Hennebelle

    Full Text Available Omega-3 fatty acids are important for several neuronal and cognitive functions. Altered omega-3 fatty acid status has been implicated in reduced resistance to stress and mood disorders. We therefore evaluated the effects of repeated restraint stress (6 h/day for 21 days on adult rats fed omega-3 deficient, control or omega-3 enriched diets from conception. We measured body weight, plasma corticosterone and hippocampus glucocorticoid receptors and correlated these data with emotional and depression-like behaviour assessed by their open-field (OF activity, anxiety in the elevated-plus maze (EPM, the sucrose preference test and the startle response. We also determined their plasma and brain membrane lipid profiles by gas chromatography. Repeated restraint stress caused rats fed a control diet to lose weight. Their plasma corticosterone increased and they showed moderate behavioural changes, with increases only in grooming (OF test and entries into the open arms (EPM. Rats fed the omega-3 enriched diet had a lower stress-induced weight loss and plasma corticosterone peak, and reduced grooming. Rats chronically lacking omega-3 fatty acid exhibited an increased startle response, a stress-induced decrease in locomotor activity and exaggerated grooming. The brain omega-3 fatty acids increased as the dietary omega-3 fatty acids increased; diets containing preformed long-chain omega-3 fatty acid were better than diets containing the precursor alpha-linolenic acid. However, the restraint stress reduced the amounts of omega-3 incorporated. These data showed that the response to chronic restraint stress was modulated by the omega-3 fatty acid supply, a dietary deficiency was deleterious while enrichment protecting against stress.

  11. Amplified spontaneous emission and its restraint in a terawatt Ti:sapphire amplifier

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Amplified spontaneous emission (ASE) and its restraint in a femtosecond Ti: sapphire chirped_pulse amplifier were investigated. The noises arising from ASE were effectively filtered out in the spatial, temporal and spectral domain. Pulses as short as 38 fs were amplified to peak power of 1.4 TW. The power ratio between the amplified femtosecond pulse and the ASE was higher than 106:1.

  12. Corticosterone responses to capture and restraint in emperor and Adelie penguins in Antarctica.

    Science.gov (United States)

    Cockrem, John F; Potter, Murray A; Barrett, D Paul; Candy, E Jane

    2008-03-01

    Birds respond to capture, handling and restraint with increased secretion of corticosterone, a glucocorticoid hormone that helps birds adjust to stressful situations. Hoods are reported to calm birds, but possible effects of hoods on corticosterone responses have not been reported for any bird. Corticosterone responses to restraint in Adelie penguins held by their legs with their head covered by a hood were markedly lower than responses of penguins restrained in a mesh bag inside a cardboard box (corticosterone at 30 min 15.69+/-1.72 cf. 28.32+/-2.75 ng/ml). The birds restrained by the two methods were sampled at the same location but in different years, so the differences in corticosterone responses cannot unequivocally be ascribed to an effect of hoods to reduce corticosterone responses. Corticosterone responses have been measured in some penguins, but not in the largest, the emperor penguin (Aptenodytes forsteri). The relationship between body mass and corticosterone responses to capture and restraint in penguins was examined in emperor penguins captured on sea ice in McMurdo Sound and Adelie penguins (Pygoscelis adeliae) captured at Cape Bird, Ross Island, Antarctica. Total integrated corticosterone responses were higher in the emperor than the Adelie penguins, but corrected integrated corticosterone responses, which represent the increase in corticosterone from initial concentrations and hence the corticosterone response to restraint, were the same. The results for the emperor and Adelie penguins, together with data from other penguin species, suggest that there is no relationship between the size of corticosterone responses and body mass in penguins.

  13. Housing in pyramid counteracts neuroendocrine and oxidative stress caused by chronic restraint in rats.

    Science.gov (United States)

    Bhat, M Surekha; Rao, Guruprasad; Murthy, K Dilip; Bhat, P Gopalakrishna

    2007-03-01

    The space within the great pyramid and its smaller replicas is believed to have an antistress effect. Research has shown that the energy field within the pyramid can protect the hippocampal neurons of mice from stress-induced atrophy and also reduce neuroendocrine stress, oxidative stress and increase antioxidant defence in rats. In this study, we have, for the first time, attempted to study the antistress effects of pyramid exposure on the status of cortisol level, oxidative damage and antioxidant status in rats during chronic restraint stress. Adult female Wistar rats were divided into four groups as follows: normal controls (NC) housed in home cage and left in the laboratory; restrained rats (with three subgroups) subject to chronic restraint stress by placing in a wire mesh restrainer for 6 h per day for 14 days, the restrained controls (RC) having their restrainers kept in the laboratory; restrained pyramid rats (RP) being kept in the pyramid; and restrained square box rats (RS) in the square box during the period of restraint stress everyday. Erythrocyte malondialdehyde (MDA) and plasma cortisol levels were significantly increased and erythrocyte-reduced glutathione (GSH) levels, erythrocyte glutathione peroxidase (GSH-Px) and superoxide dismutase (SOD) activities were significantly decreased in RC and RS rats as compared to NC. However, these parameters were maintained to near normal levels in RP rats which showed significantly decreased erythrocyte MDA and plasma cortisol and significantly increased erythrocyte GSH levels, erythrocyte GSH-Px and SOD activities when compared with RS rats. The results showed that housing in pyramid counteracts neuroendocrine and oxidative stress caused by chronic restraint in rats.

  14. Environmental Enrichment Blunts Ethanol Consumption after Restraint Stress in C57BL/6 Mice

    Science.gov (United States)

    Marianno, Priscila; Abrahao, Karina Possa

    2017-01-01

    Elevated alcohol intake after abstinence is a key feature of the addiction process. Some studies have shown that environmental enrichment (EE) affects ethanol intake and other reinforcing effects. However, different EE protocols may vary in their ability to influence alcohol consumption and stress-induced intake. The present study evaluated whether short (3 h) or continuous (24 h) EE protocols affect ethanol consumption after periods of withdrawal. Mice were challenged with stressful stimuli (24 h isolation and restraint stress) to evaluate the effects of stress on drinking. Male C57BL/6 mice were subjected to a two-bottle choice drinking-in-the-dark paradigm for 15 days (20% ethanol and water, 2 h/day, acquisition phase). Control mice were housed under standard conditions (SC). In the first experiment, one group of mice was housed under EE conditions 24 h/day (EE24h). In the second experiment, the exposure to EE was reduced to 3 h/day (EE3h). After the acquisition phase, the animals were deprived of ethanol for 6 days, followed by 2 h ethanol access once a week. Animals were tested in the elevated plus maze (EPM) during ethanol withdrawal. During the last 2 weeks, the mice were exposed to 24 h ethanol access. A 1-h restraint stress test was performed immediately before the last ethanol exposure. EE24h but not EE3h increased anxiety-like behavior during withdrawal compared to controls. Neither EE24h nor EE3h affected ethanol consumption during the 2 h weekly exposure periods. However, EE24h and EE3h mice that were exposed to acute restraint stress consumed less ethanol than controls during a 24 h ethanol access. These results showed that EE reduces alcohol intake after an acute restraint stress. PMID:28107511

  15. Social influence on temptation: perceived descriptive norms, temptation and restraint, and problem drinking among college students.

    Science.gov (United States)

    Rinker, Dipali Venkataraman; Neighbors, Clayton

    2013-12-01

    Temptation and restraint have long been associated with problematic drinking. Among college students, social norms are one of the strongest predictors of problematic drinking. To date, no studies have examined the association between temptation and restraint and perceived descriptive norms on drinking and alcohol-related problems among college students. The purpose of this study was to examine whether perceived descriptive norms moderated the relationship between temptation and restraint and drinking outcomes among college students. Participants were 1095 college students from a large, public, culturally-diverse, southern university who completed an online survey about drinking behaviors and related attitudes. Drinks per week and alcohol-related problems were examined as a function of perceived descriptive norms, Cognitive Emotional Preoccupation (CEP) (temptation), and Cognitive Behavioral Control (CBC) (restraint). Additionally, drinking outcomes were examined as a function of the two-way interactions between CEP and perceived descriptive norms and CBC and perceived descriptive norms. Results indicated that CEP and perceived descriptive norms were associated with drinking outcomes. CBC was not associated with drinking outcomes. Additionally, perceived descriptive norms moderated the association between CEP and drinks per week and CEP and alcohol-related problems. There was a positive association between CEP and drinks per week and CEP and alcohol-related problems, especially for those higher on perceived descriptive norms. College students who are very tempted to drink may drink more heavily and experience alcohol-related problems more frequently if they have greater perceptions that the typical student at their university/college drinks a lot.

  16. 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

  17. 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.

  18. Comparison of Standard Issue and ANCRA International MILVAN Restraint Beams in Static and Dynamic Environments

    Science.gov (United States)

    1990-04-01

    BEAMS IN STATIC AND DYNAMIC ENVIRONMENTS 93-10168 Prepared fo r: 1 8Distribution unlimited U.S. Army Troop Support Command ATTN: AMSTR-PLBM St. Louis ...ACCESSION NO St. Louis , MO 63120-1798 N 11 TITLE (Include Security Classification) Comparison of Standard Issue and ANCRA International MILVAN Restraint Beams...j * .** 4 ...*.**.*.* ... .* ***.***..***..*** 4-q14 drax @TO 31 aDlu \\t-I ur ne 4-1 r! S.......... .. •o

  19. Obesity susceptibility loci and uncontrolled eating, emotional eating and cognitive restraint behaviors in men and women

    OpenAIRE

    Cornelis, Marilyn C.; Rimm, Eric B; Curhan, Gary C.; Kraft, Peter; Hunter, David J; Hu, Frank B; Van Dam, Rob M.

    2013-01-01

    Objective: Many confirmed genetic loci for obesity are expressed in regions of the brain that regulate energy intake and reward-seeking behavior. Whether these loci contribute to the development of specific eating behaviors has not been investigated. We examined the relationship between a genetic susceptibility to obesity and cognitive restraint, uncontrolled and emotional eating. Design and Methods Eating behavior and body mass index (BMI) were determined by questionnaires for 1471 men and 2...

  20. Model Used for Dynamic Stability Studies in 5 Foot Free-Flight Tunnel

    Science.gov (United States)

    1938-01-01

    Model mounted in the 5-Foot Free-Flight Tunnel. This wind tunnel was used to study the dynamic stability and control characteristics of aircraft in flight. The test section of the tunnel could be tilted to permit the model to fly without restraint when sufficient lift was produced by its wings. During free-flight tests, the tunnel test technique required two engineers. One engineer stood at the side of the test section and controlled the tunnel airspeed and tilt angle while attempting to maintain the airstream relative to the model. The second engineer controlled the airplane model remotely via small wires attached to control surface actuators. The pilot stood behind the tunnel propeller and viewed the rear of the model in flight and assessed its stability and control characteristics for various test conditions. His control box can be seen at the bottom of the picture. The tunnel was authorized in 1936 and was operational in April 1937. Construction cost was $120,000. This exploratory facility was superseded by a larger 12-ft free-flight tunnel in 1939.

  1. Cognitive dietary restraint is associated with eating behaviors, lifestyle practices, personality characteristics and menstrual irregularity in college women.

    Science.gov (United States)

    McLean, Judy A; Barr, Susan I

    2003-04-01

    This study characterized associations of restraint with selected physical, lifestyle, personality and menstrual cycle characteristics in female university students. The survey instrument, distributed to 1350 women, included standardized questionnaires (Three-Factor Eating Questionnaire, Perceived Stress Scale and Rosenberg's Self-esteem Scale), and assessed weight and dieting history, exercise, lifestyle characteristics, menstrual cycle characteristics and whether participants were following vegetarian diets. Among the 596 respondents included in the analysis (44%), women with high (n=145), medium (n=262) or low (n=189) restraint had similar ages, heights and weights. Despite this, compared to women with low scores, those with high scores exercised more (4.6+/-5.3 vs. 3.2+/-3.5 h/wk), were more likely to be vegetarian (14.5 vs. 3.7%), have a history of eating disorders (13.7 vs. 1.2%), be currently trying to lose weight (80.3 vs. 15.3%), report irregular menstrual cycles (34.7 vs. 17.0%), and have scores reflecting lower self-esteem and higher perceived stress. Menstrual irregularity was an independent predictor of restraint score, and restraint score was the only variable to differentiate women with regular and irregular menstrual cycles. We conclude that women with high restraint may use a combination of behavioral strategies for weight control, and differ from women with low restraint scores in personality characteristics and weight history. Some of these behaviors or characteristics may influence menstrual function.

  2. Foot deformation during walking: differences between static and dynamic 3D foot morphology in developing feet.

    Science.gov (United States)

    Barisch-Fritz, Bettina; Schmeltzpfenning, Timo; Plank, Clemens; Grau, Stefan

    2014-01-01

    The complex functions of feet require a specific composition, which is progressively achieved by developmental processes. This development should take place without being affected by footwear. The aim of this study is to evaluate differences between static and dynamic foot morphology in developing feet. Feet of 2554 participants (6-16 years) were recorded using a new scanner system (DynaScan4D). Each foot was recorded in static half and full weight-bearing and during walking. Several foot measures corresponding to those used in last construction were calculated. The differences were identified by one-way ANOVA and paired Student's t-test. Static and dynamic values of each foot measure must be considered to improve the fit of footwear. In particular, footwear must account for the increase of forefoot width and the decrease of midfoot girth. Furthermore, the toe box should have a more rounded shape. The findings are important for the construction of footwear for developing feet.

  3. Quick foot placement adjustments during gait: direction matters

    NARCIS (Netherlands)

    Hoogkamer, W.; Potocanac, Z.; Duysens, J.

    2015-01-01

    To prevent falls, adjustment of foot placement is a frequently used strategy to regulate and restore gait stability. While foot trajectory adjustments have been studied during discrete stepping, online corrections during walking are more common in daily life. Here, we studied quick foot placement ad

  4. The Athletic Foot and Its Import to Performance during Running.

    Science.gov (United States)

    Bogdan, Richard

    In this paper, problems and conditions of the foot, including flat feet, achilles tendon problems, heel spur syndrome, digital problems, shin splints, and leg stress fractures, are examined. Ways to examine the athlete's foot and leg are described, including the one-foot test and the off weight-bearing examination. (CJ)

  5. Imaging diagnostics of the foot; Bildgebende Diagnostik des Fusses

    Energy Technology Data Exchange (ETDEWEB)

    Szeimies, Ulrike; Staebler, Axel [Radiologie in Muenchen-Harlaching, Muenchen (Germany); Walther, Markus (eds.) [Schoen-Klinik Muenchen-Harlaching, Muenchen (Germany). Zentrum fuer Fuss- und Sprunggelenkchirurgie

    2012-11-01

    The book on imaging diagnostics of the foot contains the following chapters: (1) Imaging techniques. (2) Clinical diagnostics. (3) Ankle joint and hind foot. (4) Metatarsus. (5) Forefoot. (6) Pathology of plantar soft tissue. (7) Nervous system diseases. (8) Diseases without specific anatomic localization. (9) System diseases including the foot. (10) Tumor like lesions. (11) Normative variants.

  6. 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.

  7. Factors associated with sudden death of individuals requiring restraint for excited delirium.

    Science.gov (United States)

    Stratton, S J; Rogers, C; Brickett, K; Gruzinski, G

    2001-05-01

    The purpose of this article is to identify and rank factors associated with sudden death of individuals requiring restraint for excited delirium. Eighteen cases of such deaths witnessed by emergency medical service (EMS) personnel are reported. The 18 cases reported were restrained with the wrists and ankles bound and attached behind the back. This restraint technique was also used for all 196 surviving excited delirium victims encountered during the study period. Unique to these data is a description of the initial cardiopulmonary arrest rhythm in 72% of the sudden death cases. Associated with all sudden death cases was struggle by the victim with forced restraint and cessation of struggling with labored or agonal breathing immediately before cardiopulmonary arrest. Also associated was stimulant drug use (78%), chronic disease (56%), and obesity (56%). The primary cardiac arrest rhythm of ventricular tachycardia was found in 1 of 13 victims with confirmed initial cardiac rhythms, with none found in ventricular fibrillation. Our findings indicate that unexpected sudden death when excited delirium victims are restrained in the out-of-hospital setting is not infrequent and can be associated with multiple predictable but usually uncontrollable factors.

  8. Evaluation of response to restraint stress by salivary corticosterone levels in adult male mice.

    Science.gov (United States)

    Nohara, Masakatsu; Tohei, Atsushi; Sato, Takumi; Amao, Hiromi

    2016-06-01

    Saliva as a sampling method is a low invasive technique for the detection of physiologically active substances, as opposed to sampling the plasma or serum. In this study, we obtained glucocorticoids transferred from the blood to the saliva from mice treated with 2.0 mg/kg via an intraperitoneal injection of cortisol. Next, to evaluate the effect of restraint stress using mouse saliva-collected under anesthesia by mixed anesthetic agents-we measured plasma and salivary corticosterone levels at 60 min after restraint stress. Moreover, to evaluate salivary corticosterone response to stress in the same individual mouse, an adequate recovery period (1, 3 and 7 days) after anesthesia was examined. The results demonstrate that exogenous cortisol was detected in the saliva and the plasma, in mice treated with cortisol. Restraint stress significantly increased corticosterone levels in both the plasma and saliva (Pstress significantly increased salivary corticosterone levels in all three groups (1-, 3- and 7-day recovery). However, the statistical evidence of corticosterone increase is stronger in the 7-day recovery group (Plevels in saliva reflect its levels in the plasma, and salivary corticosterone is a useful, less-invasive biomarker of physical stress in mice. The present study may contribute to concepts of Reduction and Refinement of the three Rs in small animal experiments.

  9. Metabotropic glutamate receptor-mediated signaling dampens the HPA axis response to restraint stress.

    Science.gov (United States)

    Evanson, Nathan K; Herman, James P

    2015-10-15

    Glutamate is an important neurotransmitter in the regulation of the neural portion of hypothalamus-pituitary-adrenal (HPA) axis activity, and signals through ionotropic and metabotropic receptors. In the current studies we investigated the role of hypothalamic paraventricular group I metabotropic glutamate receptors in the regulation of the HPA axis response to restraint stress in rats. Direct injection of the group I metabotropic glutamate receptor agonist 3,5-dihydroxyphenylglycine (DHPG) into the PVN prior to restraint leads to blunting of the HPA axis response in awake animals. Consistent with this result, infusion of the group I receptor antagonist hexyl-homoibotenic acid (HIBO) potentiates the HPA axis response to restraint. The excitatory effect of blocking paraventricular group I metabotropic glutamate signaling is blocked by co-administration of dexamethasone into the PVN. However, the inhibitory effect of DHPG is not affected by co-administration of the cannabinoid CB1 receptor antagonist AM-251 into the PVN. Together, these results suggest that paraventricular group I metabotropic glutamate receptor signaling acts to dampen HPA axis reactivity. This effect appears to be similar to the rapid inhibitory effect of glucocorticoids at the PVN, but is not mediated by endocannabinoid signaling.

  10. Contrasting effects of diazepam and repeated restraint stress on latent inhibition in mice.

    Science.gov (United States)

    Mongeau, Raymond; Marcello, Stefania; Andersen, Jacob Sparre; Pani, Luca

    2007-11-02

    The effects on latent inhibition (LI; a delay in conditioning when a CS has been pre-exposed without consequences) of repeated restraint stress and the anxiolytic drug diazepam were examined in C57BL/6 mice to know whether previous aversive events or anxiolysis are factors determining the expression of LI. The LI model was optimized for this strain particularly sensitive to stress (using both the CER and the conditioned freezing procedures) and characterized with typical (haloperidol) and atypical (clozapine and olanzapine) antipsychotic drugs administered either during the conditioning or the pre-exposure phases. An acute challenge with amphetamine, a dopamine releaser, was done to verify the enhancement of hyperactivity in C57BL/6 mice after the restraint stress sensitization. At all doses tested, diazepam decreased latent inhibition when administered during the pre-exposure phase (similarly to atypical antipsychotic drugs). Repeated restraint stress enhanced LI by blocking the CS-induced freezing in pre-exposed mice. In contrast, pre-treatment with diazepam before pre-exposure allowed the expression of CS-induced freezing in stressed mice pre-exposed to the tone. It is suggested that stress and anxiolytic drugs can have opposite effects on attention or perseveration processes during learning of conflicting contingency responses.

  11. Myricetin Attenuates Depressant-Like Behavior in Mice Subjected to Repeated Restraint Stress

    Directory of Open Access Journals (Sweden)

    Zegang Ma

    2015-11-01

    Full Text Available Increasing evidence has shown that oxidative stress may be implicated in chronic stress-induced depression. Several flavonoids with anti-oxidative effects have been proved to be anti-depressive. Myricetin is a well-defined flavonoid with the anti-oxidative, anti-inflammatory, anti-apoptotic, and neuroprotective properties. The aim of the present study is to investigate the possible effects of chronic administration of myricetin on depressant-like behaviors in mice subjected to repeated restraint (4 h/day for 21 days. Our results showed that myricetin administration specifically reduced the immobility time in mice exposed to chronic stress, as tested in both forced swimming test and tail suspension test. Myricetin treatment improved activities of glutathione peroxidase (GSH-PX in the hippocampus of stressed mice. In addition, myricetin treatment decreased plasma corticosterone levels of those mice subjected to repeated restraint stress. The effects of myricetin on the brain-derived neurotrophic factor (BDNF levels in hippocampus were also investigated. The results revealed that myricetin normalized the decreased BDNF levels in mice subjected to repeated restraint stress. These findings provided more evidence that chronic administration of myricetin improves helpless behaviors. The protective effects of myricetin might be partially mediated by an influence on BDNF levels and might be attributed to myricetin-mediated anti-oxidative stress in the hippocampus.

  12. [Diabetic foot osteomyelitis: is conservative treatment possible?].

    Science.gov (United States)

    Jordano-Montañez, Queralt; Muñiz-Tatay, Montse; Viadé-Julià, Jordi; Jaen-Manzanera, Angeles; Royo-Serrando, Josep; Cuchí-Burgos, Eva; Anglada-Barceló, Jordi; de la Sierra-Iserte, Alejandro

    2014-11-01

    The aim of the present study is to determine the proportion of foot ulcers, complicated by osteomyelitis in diabetic patients, that heal without amputation. Furthermore, an attempt is made to analyze the main clinical and microbiological characteristics of episodes, and to identify potential predictive factors leading to the failure of conservative treatment. A prospective observational study was carried out between 2007 and 2009 on diabetic patients with a foot lesion and attending a diabetic foot clinic. A percutaneous bone biopsy was required to be included in the study. A total of 81 episodes of diabetic foot osteomyelitis in 64 patients were evaluated. Staphylococcus aureus (28/81) and coagulase negative Staphylococcus (22/81) were the most frequent organisms isolated. Among the gramnegative group (34/81), non-fermenting gram negative bacteria were the most prevalent organisms isolated (14/81). Conservative treatment was successful in 73% of episodes. After a logistic regression analysis using the most significant prognostic variables, only lesion size greater than 2cm independently predicted failure of conservative treatment. Culture guided antibiotic treatment was associated with a better prognosis. Conservative treatment, including culture-guided antibiotics, is successful without amputation in a large proportion of diabetic patients with diabetic foot osteomyelitis. Considering empiric therapy directed at non-fermenting gramnegative bacteria could be advisable in some cases, because they are frequently isolated in our setting. Copyright © 2013 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  13. Normative values for the Foot Posture Index

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    Redmond Anthony C

    2008-07-01

    Full Text Available Abstract Background The Foot Posture Index (FPI is a validated method for quantifying standing foot posture, and is being used in a variety of clinical settings. There have however, been no normative data available to date for comparison and reference. This study aimed to establish normative FPI reference values. Methods Studies reporting FPI data were identified by searching online databases. Nine authors contributed anonymised versions of their original datasets comprising 1648 individual observations. The datasets included information relating to centre, age, gender, pathology (if relevant, FPI scores and body mass index (BMI where available. FPI total scores were transformed to interval logit scores as per the Rasch model and normal ranges were defined. Comparisons between groups employed t-tests or ANOVA models as appropriate and data were explored descriptively and graphically. Results The main analysis based on a normal healthy population (n = 619 confirmed that a slightly pronated foot posture is the normal position at rest (mean back transformed FPI raw score = +4. A 'U' shaped relationship existed for age, with minors and older adults exhibiting significantly higher FPI scores than the general adult population (F = 51.07, p t = -1.44, p = 0.149. No relationship was found between the FPI and BMI. Systematic differences from the adult normals were confirmed in patients with neurogenic and idiopathic cavus (F = 216.981, p Conclusion A set of population norms for children, adults and older people have been derived from a large sample. Foot posture is related to age and the presence of pathology, but not influenced by gender or BMI. The normative values identified may assist in classifying foot type for the purpose of research and clinical decision making.

  14. Tuberculosis of the foot: An osteolytic variety

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    Mandeep S Dhillon

    2012-01-01

    Full Text Available Background: Foot involvement in osteoarticular tuberculosis is uncommon and isolated bony involvement of foot bones with an osteolytic defect is even more rare; diagnostic and therapeutic delays can occur, worsening the prognosis. We present a retrospective series of osteolytic variety of foot tuberculosis. Materials and Methods: We present 24 osteolytic variety of foot tuberculosis (Eleven calcaneus, four cuboid, two cunieforms, one talus, three metatarsals, three phalanges out of 92 foot TB cases collected over last 20 years. There were 16 adults and eight children. Tissue diagnosis was established in 23 of 24 cases based on PCR AFB staining, culture, and histopathology. Surgical intervention was reserved for patients with either a juxtaarticular focus threatening to involve a joint or an impending collapse of a midfoot bone with cystic destruction. Results: Fifteen cases had an osteolytic lesion on the radiographs resembling a space-occupying lesion, five had patchy osteolysis, while four showed coke like sequestra; one patient had a lesion in two bones. Antitubercular chemotherapy after biopsy was sufficient to heal the lesion in 19 cases, while in five cases surgical debridement needed to be done. The lesions healed eventually. At an average followup of 8.3 years, (range 2-15 years there were no recurrences and all patients were free from pain, with no restriction of movements. Six patients complained of occasional pain during walking on uneven ground. Conclusion: When tuberculous pathology is limited to the bone, the prognosis is better than in articular disease, as there is less deformity, and hence, less residual pain and disability.

  15. Diabetic foot disease: From the evaluation of the “foot at risk” to the novel diabetic ulcer treatment modalities

    OpenAIRE

    Amin, Noha; Doupis, John

    2016-01-01

    The burden of diabetic foot disease (DFD) is expected to increase in the future. The incidence of DFD is still rising due to the high prevalence of DFD predisposing factors. DFD is multifactorial in nature; however most of the diabetic foot amputations are preceded by foot ulceration. Diabetic peripheral neuropathy (DPN) is a major risk factor for foot ulceration. DPN leads to loss of protective sensation resulting in continuous unconscious traumas. Patient education and detection of high ris...

  16. Tibialis posterior tendon transfer corrects the foot drop component of cavovarus foot deformity in Charcot-Marie-Tooth disease.

    Science.gov (United States)

    Dreher, T; Wolf, S I; Heitzmann, D; Fremd, C; Klotz, M C; Wenz, W

    2014-03-19

    The foot drop component of cavovarus foot deformity in patients with Charcot-Marie-Tooth disease is commonly treated by tendon transfer to provide substitute foot dorsiflexion or by tenodesis to prevent the foot from dropping. Our goals were to use three-dimensional foot analysis to evaluate the outcome of tibialis posterior tendon transfer to the dorsum of the foot and to investigate whether the transfer works as an active substitution or as a tenodesis. We prospectively studied fourteen patients with Charcot-Marie-Tooth disease and cavovarus foot deformity in whom twenty-three feet were treated with tibialis posterior tendon transfer to correct the foot drop component as part of a foot deformity correction procedure. Five patients underwent unilateral treatment and nine underwent bilateral treatment; only one foot was analyzed in each of the latter patients. Standardized clinical examinations and three-dimensional gait analysis with a special foot model (Heidelberg Foot Measurement Method) were performed before and at a mean of 28.8 months after surgery. The three-dimensional gait analysis revealed significant increases in tibiotalar and foot-tibia dorsiflexion during the swing phase after surgery. These increases were accompanied by a significant reduction in maximum plantar flexion at the stance-swing transition but without a reduction in active range of motion. Passive ankle dorsiflexion measured in knee flexion and extension increased significantly without any relevant decrease in passive plantar flexion. The AOFAS (American Orthopaedic Foot & Ankle Society) score improved significantly. Tibialis posterior tendon transfer was effective at correcting the foot drop component of cavovarus foot deformity in patients with Charcot-Marie-Tooth disease, with the transfer apparently working as an active substitution. Although passive plantar flexion was not limited after surgery, active plantar flexion at push-off was significantly reduced and it is unknown whether

  17. Trends in lumber processing in the western United States. Part I: board foot Scribner volume per cubic foot of timber

    Science.gov (United States)

    Charles E. Keegan; Todd A. Morgan; Keith A. Blatner; Jean M. Daniels

    2010-01-01

    This article describes trends in board foot Scribner volume per cubic foot of timber for logs processed by sawmills in the western United States. Board foot to cubic foot (BF/CF) ratios for the period from 2000 through 2006 ranged from 3.70 in Montana to 5.71 in the Four Corners Region (Arizona, Colorado, New Mexico, and Utah). Sawmills in the Four Corners Region,...

  18. The Relationship with Balance, Foot Posture, and Foot Size in School of Physical Education and Sports Students

    Science.gov (United States)

    Irez, Gonul Babayigit

    2014-01-01

    The aim of this study is to investigate the relationship of foot posture and foot size with balance. A hundred and thirteen healthy volunteers were recruited from undergraduate students (Male = 74, Female = 37, age range 18-22). The Foot Posture Index (FPI-6), anthropometric measurements, dynamic balance and static balance measurements were done…

  19. Effect of Custom-Molded Foot Orthoses on Foot Pain and Balance in Children With Symptomatic Flexible Flat Feet.

    Science.gov (United States)

    Lee, Hong-Jae; Lim, Kil-Byung; Yoo, JeeHyun; Yoon, Sung-Won; Yun, Hyun-Ju; Jeong, Tae-Ho

    2015-12-01

    To evaluate the effect of custom-molded foot orthoses on foot pain and balance in children with symptomatic flexible flat foot 1 month and 3 months after fitting foot orthosis. A total of 24 children over 6 years old with flexible flat feet and foot pain for at least 6 months were recruited for this study. Their resting calcaneal stance position and calcaneal pitch angle were measured. Individual custom-molded rigid foot orthoses were prescribed using inverted orthotic technique to control foot overpronation. Pain questionnaire was used to obtain pain sites, degree, and frequency. Balancing ability was determined using computerized posturography. These evaluations were performed prior to custom-molded foot orthoses, 1 month, and 3 months after fitting foot orthoses. Of 24 children with symptomatic flexible flat feet recruited for this study, 20 completed the study. Significant (pfoot orthoses. In addition, significant (pfoot orthoses. Short-term use of custom-molded foot orthoses significantly improved foot pain and balancing ability in children with symptomatic flexible flat foot.

  20. Visual guidance of the human foot during a step

    OpenAIRE

    Reynolds, R. F.; Day, B L

    2005-01-01

    When the intended foot placement changes during a step, either due to an obstacle appearing in our path or the sudden shift of a target, visual input can rapidly alter foot trajectory. However, previous studies suggest that when intended foot placement does not change, the path of the foot is fixed after it leaves the floor and vision has no further influence. Here we ask whether visual feedback can be used to improve the accuracy of foot placement during a normal, unperturbed step. To invest...