Clinical and Organizational Factors Related to the Reduction of Mechanical Restraint Application in an Acute Ward: An 8-Year Retrospective Analysis

Background: The purpose of this study was to describe the frequency of mechanical restraint use in an acute psychiatric ward and to analyze which variables may have significantly influenced the use of this procedure. Methods: This retrospective study was conducted in the Servizio Psichiatrico di Diagnosi e Cura (SPDC) of Modena Centro. The following variables of our sample, represented by all restrained patients admitted from 1-1-2005 to 31-12-2012, were analyzed: age, gender, nationality, psychiatric diagnoses, organic comorbidity, state and duration of admission, motivation and duration of restraints, nursing shift and hospitalization day of restraint, number of patients admitted at the time of restraint and institutional changes during the observation period. The above variables were statistically compared with those of all other non-restrained patients admitted to our ward in the same period. Results: Mechanical restraints were primarily used as a safety procedure to manage aggressive behavior of male patients, during the first days of hospitalization and night shifts. Neurocognitive disorders, organic comorbidity, compulsory state and long duration of admission were statistically significantly related to the increase of restraint use (p<.001, multivariate logistic regression). Institutional changes, especially more restricted guidelines concerning restraint application, were statistically significantly related to restraint use reduction (p<.001, chi2 test, multivariate logistic regression). Conclusion: The data obtained highlight that mechanical restraint use was influenced not only by clinical factors, but mainly by staff and policy factors, which have permitted a gradual but significant reduction in the use of this procedure through a multidimensional approach

An Explanatory Case Study on Teachers’ Attitudes Toward the Inclusion of Students with Special Needs in Rural Philippine Classrooms

This explanatory case study examined nine elementary teachers’ attitudes toward inclusive education in Odiongan North District, Romblon, between January and June 2025. Guided by the Social Model of Disability, Contact Theory, and the Theory of Planned Behavior, the study employed semi-structured, expert-validated focus group discussions, which were thematically analyzed to reveal four interrelated themes: moral and pedagogical motivations; contextual influences; gaps in formal professional development; and lived experiences. Insights informed a seven-module Inclusive Teaching Empowerment Series (ITES) addressing legal frameworks, differentiated instruction, co-teaching, reflective practice, and digital microlearning. The study highlights the need for sustained, context-responsive capacity building, leadership support, and resource allocation in rural, multigrade settings. Recommendations include integrating ITES into DepEd Learning Action Cells and formal peer-led workshops to scale inclusive practices

The effect of national stress events on the incidence of Takotsubo syndrome

We aimed to analyze whether national level stressful events were associated with an increase the incidence of Takotsubo syndrome. Takotsubo syndrome is an acute reversible heart failure, characterized by transient regional wall abnormality in the absence of a culprit coronary disease, usually caused by acute stressful etiologies. The terror attack of October 7th 2023 and the subsequent war had an enormous impact on the society in Israel. This was a multi-center, observational, analytic, retrospective, case-control study. To examine our hypothesis, we compared the incidence of Takotsubo syndrome in 7 medical centers in Israel during the period of October-December 2023 (“during war”) to the period of October-December 2022 (“before war”), both as an absolute number and as a percentage of all admissions in these 7 medical centers. During the period before the war, 20 patients (0.54 % of all admissions to the cardiology departments) were hospitalized with a proven diagnosis of Takotsubo syndrome, compared with 39 patients (1.07 % of all admissions to the cardiology departments) during the war, accounting for a 95 % increase in the absolute number, and 98 % increase in the percentage of all admissions (p = 0.01, OR = 1.98). Most of the demographic and clinical characteristics, laboratory results, ECG, echocardiogram and angiographic findings were similar between the two groups. Our study showed a significant increase in the incidence of Takotsubo syndrome in Israel during the first three months of the war, suggesting the October 7th terror attack and the consequent war was a traumatic event for the society of Israel