Weight force during prone restraint and respiratory function

Prone maximal restraint position (PMRP, also known as hogtie or hobble) is often used by law enforcement and prehospital personnel on violent combative individuals in the field setting. Weight force is often applied to the restrained individual's back and torso during the restraint process. We sought to determine the effect of 25 and 50 lbs weight force on respiratory function in human subject volunteers placed in the PMRP. We performed a randomized, cross-over, controlled trial on 10 subjects placed in 4 positions for 5 minutes each: sitting, PRMP, PRMP with 25 lbs weight force (PMRP+25), and PRMP with 50 lbs weight force placed on the back (PMRP+50). We measure pulse oximetry, end-tidal CO2 levels, and forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1). FVC and FEV1 were significantly lower in all restraint positions compared with sitting but not significantly different between restraint positions with and without weight force. Moreover, mean oxygen saturation levels were above 95% and mean end-tidal CO2 levels were below 45 mm Hg for all positions. We conclude that PMRP with and without 25 and 50 lbs of weight force resulted in a restrictive pulmonary function pattern but no evidence of hypoxia or hypoventilation.     

From D.C. to Little Rock: Welfare Reform at Mid-term

Following an active period of state welfare reforms, passageof the Temporary Assistance for Needy Families (TANF) programin 1996 gave states great flexibility, set up block-grant financing,and imposed work-related mandates. Under TANF, states increasedtheir work expectations for recipients; improved work incentives;and provided more work supports, such as child care and transportationassistance. Caseloads have dropped sharply, and most formerrecipients are finding work. Caseload declines in most stateshave resulted in substantial funding being available for newand expanded services, including supports for working poor familiesand early-childhood and after-school programs. Most states havebeen slower to develop these programs, but the pace is increasingas policymakers become more secure about TANF's flexibilityand the magnitude of the caseload changes.