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

<p>Abstract</p> <p>Background</p> <p>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.</p> <p>Method</p> <p>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.</p> <p>Results</p> <p>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.</p> <p>Conclusion</p> <p>Studies about restraints and restraint use have mostly focused on nurses' inadequate and often inaccurate knowledge about the use of restraints and its associated adverse effects. These studies, however, fail to note that nurses can also be victims of the system. Restraint use is a complex issue that needs to be understood in relation to the dynamics within an environment.</p

Clinical and radiographic investigation of the adjunctive effects of a low-power he-ne laser in the treatment of moderate to advanced periodontal disease: A pilot study

Objective: To evaluate the adjunctive effect of a low-power He-Ne laser in the non-surgical periodontal treatment of patients with moderate to advanced chronic periodontitis. Background Data: Laser applications in dental treatment are now more common in the literature. However, limited data are available on the potential effects of the low-power laser as an adjunct to non-surgical periodontal therapy for managing patients with moderate to advanced periodontal disease. Materials and Methods: Sixteen patients with probing pocket depth (PPD) ≥5 mm and comparable bone defects on both sides of the mouth were recruited. Supragingival plaque (PL), bleeding on probing (BOP), PPD, and probing attachment level (PAL) were recorded at baseline and at 3, 6, 9, and 12 mo, while gingival crevicular fluid (GCF) samples and standardized intra-oral radiographs for digital subtraction radiography were taken at baseline and at 1, 3, 6, 9, and 12 mo. After non-surgical mechanical periodontal treatment, the test sites were selected randomly and irradiated with a low-power He-Ne laser (output power 0.2 mW) for 10 min for a total of eight times in the first 3-mo period, while the control sites received no additional treatment. Results: PL percentage (83-16%) and BOP percentage (95-34%) decreased significantly after 12 mo. Statistically significant changes in reductions of PPD and GCF volume, gain in PAL, and increase in recession were seen in both test and control sites when compared to baseline (p < 0.05). No statistically significant differences in any clinical parameters or radiographic findings were found between the test and control sites. Changes in GCF volume were significant only at 3 mo in the test sites. Conclusion: Within the limits of this pilot study, the use of the low-power He-Ne laser as an adjunct to non-surgical periodontal therapy in patients with moderate to advanced chronic periodontitis did not seem to provide additional clinical benefit. © 2009 Mary Ann Liebert, Inc.published_or_final_versio

A randomized controlled trial of a specific reminiscence approach to promote the well-being of nursing home residents with dementia

Background: To date, no firm conclusions can be reached regarding the effectiveness of reminiscence for dementia. Researchers have emphasized that there is an urgent need for more systematic research in the area. Objective and Method: A single-blinded, parallel-groups (one intervention, one comparison, and one no-intervention group) randomized controlled trial (RCT) was adopted to investigate whether a specific reminiscence program leads to higher levels of psychosocial well-being in nursing home residents with dementia. The intervention adopted a life-story approach, while the comparison group provided friendly discussions to control for any changes in outcome as a result of social contacts and attention. The Social Engagement Scale (SES) and Well-being/Ill-being Scale (WIB) were the outcome measures used. The outcomes of the groups were examined with reference to the baseline (T0), immediately (T1), and six weeks (T2) after intervention. The final sample had 101 subjects (control group: n=30; comparison group: n=35; intervention group: n=36). Using multivariate analysis with repeated measures, no significant differences in outcome were found between groups at either T1 or T2. Wilcoxon signed rank tests were performed for each group comparing outcomes between T1 and T0, T2 and T1, and T2 and T0. Significant differences were observed in the intervention group when comparing T1 and T0 WIB (p=.014), but not for the other groups. Conclusion: Although the intervention did not lead to significant differences between the three groups over time, there was a significant improvement in psychosocial well-being for the intervention group.published_or_final_versio

Anomalous diffusivity and electric conductivity for low concentration electrolytes in nanopores

The dynamic properties of electrolytes in nanopores were studied using the equilibrium and non-equilibrium molecular dynamic simulations. The realistic primitive model and the restrictive primitive models that were widely used in liquid state theory were applied to the electrolyte model. The electrolytic ions that were found to be immersed in the water were treated as dielectric continuum or macroscopic dielectric continuum. Simulation studies for the discrete solvent primitive model were performed and detailed analysis of the characteristics of the ion radial density functions was done.published_or_final_versio

A cost-effective digital forensic investigation model

Computers operate at discrete points in time and hence digital traces are discrete events in temporal logic that re°ect the occurrence of computer processes. From the perspective of a digital investigation, it is the duty of digital investigators or forensic examiners to retrieve digital traces so as to prove or to refute the alleged computer acts. Given the resource constraints of most organizations and the limited time-frame available for the examination, it is not always feasible or indeed necessary for forensic examiners to retrieve all the related digital traces and to conduct a thorough digital forensic analysis. It is therefore the aim of this paper to propose a model that can o®er swift and practical digital examination in a cost-effective manner.postprin

The role of clinical microbiologists in infectious disease management

All infectious disease consultations directed to the clinical microbiologists at the Queen Mary Hospital in February 1995 were analysed. A total of 95 written and 111 telephone consultations were received. Fifty three percent of the written consultations involved patients with persistent fever despite multiple antimicrobial therapy. Of all written consultations, gram positive bacteria, gram negative bacteria, and fungi were encountered in 39%, 31%, and 19%, respectively. The majority of written consultations (55%) were from surgical units. In contrast, 65% of telephone consultations came from medical and paediatric units. This study indicated that a wide spectrum of infectious disease problems - both diagnostic and therapeutic - were encountered by clinical microbiologists. The unique combination of laboratory skill and clinical infectious disease knowledge gives the microbiologist a distinctive advantage in assisting clinicians to provide optimal care to patients suffering from infection.published_or_final_versio

Adjunctive effect of low-power laser in periodontally involved infrabony defects

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Mirizzi syndrome associated with hepatic artery pseudoaneurysm: a case report.

INTRODUCTION: This is the first case report of Mirizzi syndrome associated with hepatic artery pseudoaneurysm. CASE PRESENTATION: A 54-year-old man presented with painful obstructive jaundice and weight loss. Computed tomography showed a hilar mass in the liver. Following an episode of haemobilia, angiography demonstrated a pseudoaneurysm of a branch of the right hepatic artery that was embolised. At surgery, a gallstone causing Mirizzi type II syndrome was found to be responsible for the biliary obstruction and a necrotic inflammatory mass and haematoma were found to be extending into the liver. The mass was debrided and drained, the obstructing stones removed and the bile duct drained with a t-tube. The patient made a full recovery. CONCLUSION: This case highlights another situation where there may be difficulty in differentiating Mirizzi syndrome from biliary tract cancer.Published versio

Adjunctive use of a low-power laser in periodontal therapy

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Digital evidence search kit

With the rapid development of electronic commerce and Internet technology, cyber crimes have become more and more common. There is a great need for automated software systems that can assist law enforcement agencies in cyber crime evidence collection. This paper describes a cyber crime evidence collection tool called DESK (Digital Evidence Search Kit), which is the product of several years of cumulative efforts of our Center together with the Hong Kong Police Force and several other law enforcement agencies of the Hong Kong Special Administrative Region. We will use DESK to illustrate some of the desirable features of an effective cyber crime evidence collection tool. © 2005 IEEE.published_or_final_versio