Restraining good practice: Reviewing evidence of the effects of restraint from the perspective of service users and mental health professionals in the United Kingdom (UK)

Safeguarding, balancing the concept of risk with the need for public protection and its implication for the lives of individuals, is an important facet of contemporary mental health care. Integral to safeguarding is the protection of human rights; the right to live free from torture, inhuman, or degrading treatment, and having the right to liberty, security, respect, and privacy. Professionals are required to recognise all of these rights when delivering care to vulnerable people. In the United Kingdom (UK) there has been growing public concern regarding abusive practices in institutions, with a number of unacceptable methods of restraint being identified as a feature of care, particularly in mental health care. In keeping with the service user movement, and following a review of the literature, this paper discusses the evidence regarding restraint from the perspectives of service users and professionals within mental health services and considers the implications for future practice and research. In reviewing the literature, findings revealed that restraint can be a form of abuse, it's inappropriate use often being a consequence of fear, neglect, and lack of using de-escalation techniques. Using restraint in this way can have negative implications for the well-being of service users and mental health professionals alike.

Starvation and nutrient resuscitation of Klebsiella pneumoniae isolated from oil well waters

Klebsiella pneumoniae isolated from oil well waters reduced in size in response to nutrient starvation. The cells remained viable during starvation and later were able to grow rapidly when stimulated by nutrients. The heterotrophic potential, culture absorbance and extracellular polysaccharide production decreased during cell starvation whereas an initial increase in colony-forming units was observed on agar plates. Transmission electron microscopy (TEM) after 24 d revealed that the cells had changed to small rods or cocci between 0.5 by 0.25 micron and 0.87 by 0.55 micron. When transferred to half-strength brain heart infusion medium, TEM showed cell division and rod-shaped cells after 45 min and full resuscitation within 4 h. Cell response was much slower in sodium citrate medium and resuscitation took 8 h.

Nutrient Resuscitation and Growth of Starved Cells in Sandstone Cores: a Novel Approach to Enhanced Oil Recovery

Klebsiella pneumoniae , which was reduced in size (0.25 by 0.5 μm) by carbon deprivation, was injected into a series of sandstone cores and subjected to separate treatments. Scanning electron microscopy of 400-mD cores showed these small starved cells in nearly every core section. The cells were a mixture of small rods and cocci with little or no biofilm production. Continuous or dose stimulation with sodium citrate allowed the cells to grow throughout the sandstone and completely plug the length of the core. The resuscitated cells were larger than the starved cells (up to 1.7 μm) and were encased in glycocalyx. Scanning electron microscopic results of resuscitation in situ with half-strength brain heart infusion broth showed that a shallow “skin” plug of cells formed at the core inlet and that fewer cells were located in the lower sections. Starved cells also penetrated 200-mD cores and were successfully resuscitated in situ with sodium citrate, so that the entire core was plugged. Nutrient resuscitation of injected starved cells to produce full-size cells which grow and block the rock pores may be successfully applied to selective plugging and may effectively increase oil recovery.