Physical restraint of children and adolescents in mental health inpatient services:A systematic review and narrative synthesis

Physical restraint is regularly used in children and adolescent mental health care, often as a reactive behaviour management strategy. Physical restraint has been associated with physical injury, but psychological consequences are poorly understood. The aim of this systematic review was to examine physical restraint of children and adolescents in inpatient mental healthcare services. Healthcare databases were searched to identify English language publications discussing anyone aged ≤18 years who had experienced physical restraint as a mental health inpatient. No date restrictions were applied. Sixteen quantitative studies are included within this review. Most studies are retrospective in nature. Publications were appraised using the Critical Appraisal Skills Programme quality assessment tool. Common characteristics associated with children and adolescents who experience physical restraint include age, gender, diagnosis, and history. Most studies associate physical restraint with the management of aggression. Findings suggest that it may be a combination of patient (intrinsic) and environmental (extrinsic) factors which ultimately lead to children and adolescents experiencing restraint. This review confirms that little is known about children and adolescents’ first-hand experiences of physical restraint. Future research should address children and adolescents’ perceptions and first-hand experiences of physical restraint

Preventing Accidents in Offshore Oil and Gas Operations: The U.S. Approach and Some Contrasting Features of the Norwegian Approach

This working paper deals with the U.S. approach for governing the safety of offshore oil and gas operations and preventing major accidents during exploratory drilling and production. It evaluates the statutory and regulatory framework, and agency implementation and reliance on industrial standards, and then suggests reforms to improve the efficacy of this governance system. References are made to the blowout at the drilling rig operated by British Petroleum to support the evaluation and reforms. References are also made to Norwegian laws and regulations governing oil and gas operations in the North Sea. As one of the world’s largest sources of offshore oil and natural gas, Norway has achieved a high level of safety and offers a proven alternative approach for consideration in the development of an improved U.S. approach. Several additional sections are being developed to complete this working paper