Adverse effects associated with physical restraint.

OBJECTIVE: Restraint use is not monitored in the US, and only institutions that choose to do so collect statistics. In 1999, investigative journalists reported lethal consequences proximal to restraint use, making it a life-and-death matter that demands attention from professionals. This paper reviews the literature concerning actual and potential causes of deaths proximal to the use of physical restraint. METHOD: Searching the electronic databases Medline, Cinahl, and PsycINFO, we reviewed the areas of forensics and pathology, nursing, cardiology, immunology, psychology, neurosciences, psychiatry, emergency medicine, and sports medicine. CONCLUSIONS: Research is needed to provide clinicians with data on the risk factors and adverse effects associated with restraint use, as well as data on procedures that will lead to reduced use. Research is needed to determine what individual risk factors and combinations thereof contribute to injury and death.     

Development of self-concept in Afro-American children

Studies of self-concept in Afro-American children differ in their findings according to whether the research was conducted before or after the civil rights movement of the 1960s. While the earlier studies reported that the Afro-Americans had lower self-esteem than Caucasians, studies conducted after the height of the civil rights movement do not support that finding. The development of self-concept in Afro-American children is influenced by the strengths and weaknesses of the family, extended family, or community; individual perceptions of untoward events or environments; and the ability to devise mechanisms to ward off threats to self-esteem. The author stresses that those who study self-esteem among Afro-Americans should examine developmental processes within the individual's social context and reference groups rather than from the perspective of the dominant group.     

Evaluation of a peer assessment approach for enhancing the organizational capacity of state injury prevention programs.

To conduct a formative and pilot impact evaluation of the State Technical Assessment Team (STAT) program, a visitation-based (visitatie) peer assessment program designed to enhance the organizational capacity of state health department injury prevention programs. The formative evaluation was based on observational, record review, and key informant interview data collected during the implementation of the first 7 STAT visits. Pilot impact data were derived from semi-structured interviews with state injury prevention personnel one year after the visit. Formative evaluation identified 6 significant implementation problems in the first visits that were addressed by the program planners, resulting in improvements to the STAT assessment protocol. Impact evaluation revealed that after one year, the 7 state injury prevention programs had acted on 81% of the recommendations received during their STAT visits. All programs reported gains in visibility and credibility within the state health department and increased collaboration and cooperation with other units and agencies. Other significant program advancements were also reported. Specific program standards and review procedures are important to the success of peer assessment programs such as STAT. Early impact evaluation suggests that peer assessment protocols using the visitatie model can lead to gains in organizational capacity.     

The telephone survey: a methodological strategy for obtaining information

Studies have shown that students and the general population have little knowledge about nursing schools and the nursing profession. This study investigates the extent to which a sample of the population of Brazil is aware of the existence of nursing schools, and how they have obtained this information. Data were collected by telephone interviews. The sample consisted of 326 subjects whose telephone numbers were taken from the telephone book. Analysis showed that 73% of the subjects were aware of the existence of two nursing schools in the city; however, 65.03% did not know the names of these schools. Direct communication with friends and family, as well as indirect communication by television and advertising, were the sources of information mentioned by those questioned.     

Aging of the erythrocyte. X. Immunoelectrophoretic studies on the denaturation of superoxide dismutase

Superoxide dismutase (SOD) content estimated by rocket immunoelectrophoresis did not differ in various density (age) fractions of bovine erythrocytes though its specific activity decreased with increasing cell density. No changes were found, either, in the crossed immunoelectrophoretic pattern of SOD with increasing red cell age. Effects of different denaturing agents on the immunoelectrophoretic pattern and activity of the enzyme were compared, including H₂O₂ and free radicals generated by ionizing radiation. The yield for inactivation was higher than that for loss of antigenic properties in all cases studied which could correspond to the in vivo situation. However, changes in electro-phoretic mobility were revealed for all the denaturing agents, which is contrary to a main causative role of these agents in the in vivo inactivation of SOD. The results suggest spontaneous “subtle denaturation” as a chief cause for the SOD inactivation during erythrocyte aging.     

Size fractions of ambient particulate matter induce granulocyte macrophage colony-stimulating factor in human bronchial epithelial cells by mitogen-activated protein kinase pathways

Environmental pollutants, including ambient particulate matter (PM), increase respiratory morbidity. Studies of model PM particles, including residual oil fly ash and freshly generated diesel exhaust particles, have demonstrated that PM affects inflammatory airway responses. Neither of these particles completely represents ambient PM, and therefore questions remain about ambient particulates. We hypothesized that ambient PM of different size fractions collected from an urban environment (New York City air), would activate primary culture human bronchial epithelial cells (HBECs). Because of the importance of granulocyte-macrophage colony-stimulating factor (GM-CSF) on inflammatory and immunomodulatory processes, we focused our studies on this cytokine. We demonstrated that the smallest size fraction (ultrafine/fine; < 0.18 micro m) of ambient PM (11 micro g/cm(2)), upregulated GM-CSF production (2-fold increase). The absence of effect of carbon particles of similar size, and the day-to-day variation in response, suggested that the chemical composition, but not the particle itself, was necessary for GM-CSF induction. Activation of the extracellular signal-regulated kinase and the p38 mitogen-activated protein kinase was associated with, and necessary for, GM-CSF release. These studies serve to corroborate and extend those on model particles. Moreover, they emphasize the role of the smallest size ambient particles in airway epithelial cell responses.