Reasons For Restraint Research Articles

Fragments of the Body: Woman in Socialist Screen Advertising

The advertising of state socialism is often referred to as a paradox or oxymoron, yet it has produced images that shaped the consumer imagination and consumer values of socialist society. One of the critical topics in Czechoslovak socialist television advertising discourse was using an actor or a model. The socialist values of leveled consumption refused to promote consumption for property and create social distinctions through advertising and consumption. These beliefs fundamentally shaped the image of the body in socialist advertising. In this text, therefore, I discuss how the morality of socialist advertising, together with the evolving gender discourse, supported the methods of hiding, masking, or fragmenting the female body in socialist screen advertising. Based on the analysis of a vast corpus of advertisements, I follow the development of this trend from the 1960s to the 1980s, compare screen advertising with other types of advertising media, and argue that the reason for restraint in the explicit representation of the female body was, among other things, the specific hierarchy of the media in the geography of the consumer imagination of socialist Czechoslovakia.

Factors associated with prolonged episodes of mechanical restraint in mental health hospitalization units in Andalusia.

WHAT IS KNOWN ON THE SUBJECT?: Risk factors associated with prolonged episodes of mechanical restraint and other coercive measures are understudied. There have been no studies of this phenomenon in the context of the Andalusian public health system. Knowledge about factors associated with prolonged episodes is essential to increase the understanding of this phenomenon and develop strategies to reduce its occurrence. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: In Andalusia, prolonged restraint is still frequent and varies depending on the unit. It is associated with less time since admission, male gender, diagnosis, reason for restraint and the shift on which it was initiated. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Interventions at the level of the units could be necessary to prevent prolonged episodes of mechanical restraint. The results suggest the need for stricter control during the shifts on which restraint starts, especially in the first days after the patient's admission. Preventive risk assessment considering clinical and sociodemographic risk factors could help to reduce prolonged restraint. ABSTRACT: Introduction Factors associated with prolonged episodes of mechanical restraint and other coercive interventions are not clearly established and have been not studied in Andalusia (Spain). Aim To study factors associated with prolonged episodes of mechanical restraint. Method We analysed retrospectively episodes of mechanical restraint (N=6267, prolonged episode >9.5hours) in all public mental health hospitalization units (N=20, 535 beds) that offer health coverage for the autonomous community of Andalusia. The data came from clinical records. A multivariable mixed logistic regression was used. Results In Andalusia, prolonged restraint is still frequent and varies depending on the unit. It is associated with less time since admission, male gender, diagnosis, reason for restraint and the shift on which it was initiated. Discussion The results provide evidence that prolonged episodes largely depend on the unit where they occur and that stricter control and regulation are necessary to prevent prolonged episodes. Implications for practice Interventions at the level of the unit are necessary. Stricter control in the shifts during which there is more risk of prolonged restraint may be necessary, especially in the first days following admission.

Agitation and Restraint in a Pediatric Psychiatric Emergency Program: Clinical Characteristics and Diagnostic Correlates.

Agitation and restraint among pediatric psychiatric patients are a frequent, yet little studied, source of morbidity and, rarely, mortality in the emergency department (ED). This study examined agitation and restraint among youth patients in a specialized pediatric psychiatric ED, considering clinical and sociodemographic characteristics of those who required restraint to determine the clinical correlates of agitation and restraint in this population. This descriptive study was a 6-year retrospective chart review of all patients restrained for acute agitation. Demographics, clinical characteristics, diagnoses, and reasons for restraint were collected. Relationships between sociodemographic and clinical variables to types of restraints used were examined, along with change over the study period in rate of and mean time in restraint. The average restraint rate was 1.94%, which remained fairly consistent throughout study period, although average time in restraint decreased significantly. Restraints were more common in males. Adolescents were overrepresented in the ED population, and after controlling for this, restraint rates were similar in adolescents and younger children. Physical aggression was the most frequent precipitant, although among adolescents verbal aggression was also a precipitant (more so than in younger children). Disruptive behavior disorder diagnoses were most frequently associated with restraint. A lower rate of restraint is reported here than has been seen in programs where youths are treated in medical or adult psychiatric EDs. Hospitals without specialized pediatric psychiatric emergency programs should invest in staff training in deescalation techniques and in access to pediatric psychiatric treatment. The finding that, of youth restrained, a significant proportion were under 12 years old and/or carried diagnoses not typically associated with aggressive behavior, indicates that crisis prevention, management, and treatment should include younger populations and diverse diagnostic groups, rather than focusing narrowly on older patients with psychotic or substance use disorders.

Endovascular thrombectomy in patients with large infarctions: reasons for restraint

Endovascular thrombectomy in patients with large infarctions: reasons for restraint

Physical Restraint – the Gender Divide

Aim To evaluate patterns of physical restraint across a mental health trust. Introduction Physical restraint has historically been used to manage mental health crises; however there has been a recent trend for reducing this, not least because physical restraint is associated with the risk of physical harm to patients, but also psychological harm and is potentially damaging to therapeutic relationships. A commonly cited reason is violent or aggressive behaviour; however other contributory factors may play a role. We set out to evaluate the characteristics of restrained patients to see if patterns emerged that would explain this. Method Retrospective review of monthly trust-wide restraint data from 1 January – 30 June 2014. Anonomysed data was collected and analyzed using Excel. All restraints documented through the official reporting system in this period was included. Patient characteristics and reasons for restraint were evaluated. Results The majority of restraints across the trust occurred in Acute Services with 24% on a single ward for Older Adults. 20.7% was recorded on the women's medium secure ward. Within Secure Services there was a significant gender difference in the use of restraint; 94.5% in female wards and 4.5% in male wards. Significant differences in the reasons for restraint were noted. Female patients were mostly restrained for anti-social behaviour or self-harm and male patients for physical assaults. Implications Better understanding of reasons and patterns relating to use of restraints is likely to assist in developing improved management plans to reduce the overall use of physical restraint in women's services.

Mechanische Bewegungseinschränkungen: Die klinische Praxis an einer psychiatrischen Universitätsklinik

Public opinion on psychiatric medicine is still dominated by images of repression; in particular, the aspects of involuntary admissions, restraint, isolation, or involuntary administration of medication contribute significantly to public prejudice. Furthermore, violations of individual privacy rights and the use of coercion in psychiatry is an ethical challenge. The aim of this study was to describe the "practice of mechanical restraint" at a university hospital in Austria. In this study, all admissions to the closed ward at the Department of Psychiatry of the University Clinic of Innsbruck between July and December 2009 were assessed through retrospective data analysis. 529 admissions were identified during the study period. In 148 admitted patients mechanical restraint was arranged at least once. Mechanical restraint was used most frequently and over the longest period of time in patients of the ICD diagnosis group F0. In most cases, "self- harm" had been the reason for restraint. Fourteen percent of the restraints were due to a "danger to others". In patients with "danger to others", a 5 point fixation was used significantly more often than in patients without danger to others, where a restriction by bedrail and/or abdominal belt was most common. A comparison of these data with those of other centers is limited due to diverse documentation systems. A unified approach in terms of an effective quality management would be desirable in this regard.

Lasers and photodynamic therapy in the treatment of onychomycosis: a review of the literature.

Onychomycosis is a widespread problem. Oral antifungal medications are currently the gold standard of care, but treatment failure is common and oral therapy is contraindicated in many cases. There is a need for effective treatment without the systemic complications posed by oral therapy. Laser and photodynamic therapy may have the potential to treat onychomycosis locally without adverse systemic effects; some small studies have even reported achieving clinical and mycologic cure. However, there is reason for restraint; these therapies are expensive and time-consuming. Furthermore, they may not be covered by insurance and have not been proven effective with randomized, controlled clinical trials. This paper will review current literature regarding the use of laser and photodynamic therapy as potential treatments for onychomycosis.

The closest brush: How a UN secretary-general averted doomsday

A half-century after the Cuban Missile Crisis, the world still overlooks the role played by U Thant—the quiet, unassuming UN secretary-general from Burma—in helping the superpowers resolve their crisis and avert nuclear war. Thant sent early and important messages to President John F. Kennedy and Soviet Premier Nikita Khrushchev. The first requested a moratorium on the conflict at sea. Although many of Kennedy’s advisers looked upon Thant’s initiative with derision, Kennedy asked Thant to send another message requesting a cessation of Soviet shipping. The message gave Khrushchev a way to stop his ships but still save face. This ended the threat of a naval confrontation and enabled the superpowers to focus on the deeper issues of the conflict. Early on, Thant also proposed and pushed the idea that eventually formed the basis of agreement: Soviet missile withdrawal in exchange for guarantees of Cuban security. During moments in the crisis when many were calling for an attack on Cuba, Kennedy and Secretary of State Dean Rusk cited Thant’s initiatives as reasons for restraint. Thant also shuttled to Cuba to mollify Prime Minister Fidel Castro and to confirm that missile dismantlement had begun. He then aided the negotiations between Soviet and American teams at the United Nations to resolve remaining issues, such as how the missile withdrawal was to be verified.

Understanding unethical retail disposition practice and restraint from the consumer perspective

This research expands marketing's knowledge regarding unethical retail disposition (URD). URD is a type of consumer fraud, whereby consumers purchase an item of merchandise with the intent of using it and returning it to a retailer for a refund. The authors first employ grounded theory methodology to develop an original framework illustrating why consumers engage in either URD participation or restraint; next, they demonstrate empirical support for the framework. The authors support and augment previous URD research by reporting that URD offenders employ eight neutralization techniques to remedy personal guilt associated with committing the fraudulent behavior. This research also takes a novel approach by illustrating that consumers describe six motivations underlying URD restraint. Most concerning for retailers is that four of the six reasons for restraint are tenuous. Thus, consumers who refrain from URD may be easily swayed to participate in this illicit behavior. The authors posit that URD may represent a means by which consumers express disdain and mistrust for contemporary retailers, contributing to the societal discrimination that retail organizations owned by “middlemen minorities” engaged in trade and commerce often experience. © 2010 Wiley Periodicals, Inc.

Judicial restraint in the pursuit of justice

This article examines the reasons in favour of judicial restraint in human-rights adjudication. It seeks to address the worry that a strategy of restraint may lead judges to refrain from protecting rights, or, at least, to refrain from protecting them to an optimal degree. Beyond this, it considers the way in which the concern to protect the reputation of the courts can give rise to judicial restraint. Finally, it explores the possibility that complete honesty may not be the best judicial policy when judges come to justify and explain their reasoning. Judges may have to be restrained about expressing their reasons for restraint.

JUDICIAL RESTRAINT IN THE PURSUIT OF JUSTICE

This article examines the reasons in favour of judicial restraint in human-rights adjudication. It seeks to address the worry that a strategy of restraint may lead judges to refrain from protecting rights, or, at least, to refrain from protecting them to an optimal degree. Beyond this, it considers the way in which the concern to protect the reputation of the courts can give rise to judicial restraint. Finally, it explores the possibility that complete honesty may not be the best judicial policy when judges come to justify and explain their reasoning. Judges may have to be restrained about expressing their reasons for restraint.

The reasons for using restraint and seclusion in psychiatric inpatient care: A nationwide 15-year study

Background: The containment or the prevention of actual violence is the primary justification for the use of restraint and seclusion in psychiatry. The aim of the present study was to determine the grounds for using restraint and seclusion in clinical practice in Finland, and whether these reasons have changed over a 15-year period as a result of legislative changes. Method: A structured postal survey concerning the reasons for restraint and seclusion was completed in all the Finnish psychiatric hospitals during a predetermined week in 1990, 1991, 1994, 1998 and 2004. The duration of the episode as well as demographic and clinical information on the restrained and secluded patient were also reported. Results: Agitation/disorientation was the most frequent reason for the use of restraint and seclusion. The duration of the restraint and seclusion episodes was not determined by the reason for using these measures. Some differences in the reasons were found among subgroups of patients. Conclusion: Clinical practice deviates from the theoretical and legal grounds established for restraint and seclusion, and is too open to subjective assessment and interpretations.

Restraint use in inpatient rehabilitation: Incidence, predictors, and implications

The use of mechanical restraints in rehabilitation facilities focuses attention on the conflict between patient safety and independent physical function. To evaluate restraint use, we reviewed records of 323 inpatient rehabilitation admissions. Restraint orders were written for 78.3% of admissions, but used in only 32.2% of cases (mean duration of use was 16 days). Posey vests were most commonly used (78.2%). Reasons for restraint were previous fall (26.8%), impulsivity (23.7%), and inappropriate self-transfers (19.6%). Male sex, decreased mental status, low admission functional independence measure (FIM) score, stroke, or traumatic brain injury were closely associated with restraint use. Falls occurred in 25% of restrained and 10.1% of unrestrained patients. Conclusions are as follows: (1) although physician orders are required to apply restraints, nursing staff initiate, monitor, and discontinue restraint use independently; (2) traumatic brain injury or stroke, decreased admission mental status, lower FIM scores, and male sex are indicators of restraint use; (3) age is not associated with restraint use; and (4) restraints may not prevent falls.

Commentary: Philosophers at the Bar—Some Reasons for Restraint

... [T]oo many discussions of scientific rationality and progress have been both uninformed by, and inapplicable to, the actual course of the evolution of science. The various well known philosophical models of rationality have been shown to be inapplicable to most of those cases in the history of science where, at least intuitively, we are convinced that sensible rational choices are being made.... fW]e should nonetheless be able to demand of any model of science that it substantially 'fit' the actual course of scientific change. -Larry Laudan2

GRANULOCYTOPENIA WITH CIMETIDINE — A reason for restraint in prescribing this drug?

GRANULOCYTOPENIA WITH CIMETIDINE — A reason for restraint in prescribing this drug?

Prognostic Factors in the Assessment of Male Transsexuals for Sex Reassignment

SummaryTo bring to light the particular circumstances which from the outset weigh against the prospect of a successful result of sex reassignment the authors describe five male cases of transsexualism all of whom subsequently regretted the measure taken for sex reassignment. The number of factors suspected to be prognostically unfavourable was to a statistically significant degree more common among five ‘repentant’ cases than among nine cases with favourable outcome. It was also evident that the patients with unfavourable outcome were considerably older when they first sought help with the aim of obtaining sex reassignment. The results suggest that the more of such factors there are present in a particular case the stronger are the reasons for restraint in embarking upon a course of active intervention.

Biographical Aspects of Eluard's Poetry

The life of Paul Eluard holds a remarkable number of mysteries for that of a man who became prominent rather young and whose friends frequently made a particular effort to have themselves talked about. Specifically, three crises from the first period of his career, when he was attached to the surrealist movement, are either avoided or barely mentioned by biographers: the strange disappearance from Paris in 1924 which turned out to be a trip around the world; the breakup of Eluard's first marriage in 1930; and the rupture with Breton and the surrealists in 1938. Our ignorance about these questions does not stem from a lack of witnesses, but rather from the tendency of some of the poet's friends to withhold information for reasons of tact, and the tendency of others to write with such an evident bias that their testimony is unreliable. Doubtless we will soon be better informed, since every year new documents appear, and the reasons for restraint or excess become regularly less compelling.