Child protection: a survey of psychiatrists' knowledge and attitudes

The aim of the study was to examine psychiatrists' knowledge of the child protection process and their attitudes toward child protection training. An anonymous questionnaire survey was sent out to all psychiatric staff in a large psychiatric hospital. The response rate was 72 per cent. Fifty‐seven per cent of respondents had never attended child protection training and 16 per cent thought that it was of no relevance to their position. Significant differences in self‐rated knowledge were identified between those who had attended training and those who had not. Variations in the availability and quality of child protection training may result in psychiatrists not attaining the core knowledge required in order to work effectively as part of the child protection process. Hospital management should work towards prioritising and disseminating local child protection policies and procedures more effectively and consider routine child protection training as part of any new staff induction. The Royal College of Psychiatrists should consider inclusion of child protection in junior staff education programmes and as part of the MRCPsych examination curriculum. Likewise, consideration should be given to enhancing the status of child protection training in continuing professional development programmes for career‐grade psychiatric staff. Copyright © 2010 John Wiley & Sons, Ltd.     

The prevailing cultures and staff dynamics in children's homes: implications for training

This paper is about training, and the learning needs of residential child care staff that training should address. It takes as its starting point research that focused on what happens in children's homes, as described by residential staff themselves. It depicts the tasks which staff carry out in relation to their overall goal of benefiting the children and young people in their care, and considers the ways in which staff work to develop and maintain viable and effective teams. Distinctive cultures emerge when working in staff teams, and the paper shows how these are related to the kinds of practice that can be achieved in residential settings. The knowledge base, practice skills, and personal qualities required to work within residential child care are detailed. The paper closes by addressing the implications which this research has for training residential staff to work effectively in group settings. It argues that fundamental to training competent residential staff is a commitment to developing an ongoing culture of learning in workplace settings.     

Externalized anxieties in summer schools and what they reflect about institutional integration

Consultation with working groups in the Open University (OU) suggests limitations of such activities conducted by staff from within their own institution and the usefulness of psychodynamic theory. Results of a consultation with summer school staff over a ten month period demonstrate the isolation individuals and groups may experience in a large complex institution, the pain of some relationships and the possible effects upon work. The results raise the question of what support institutions might give in this area without being personally invasive or interfering with creative work. Finally, what training should be undertaken by staff who are academics rather than therapists to conduct such work effectively and safely?     

The professional's psychological response in disaster: implications for practice.

1. Victims typically experience recurring and distressing thoughts about a disaster and attempt to avoid thoughts and behavior associated with the event. As one works through the stressful event, the victim vacillates between intrusion and avoidance, with the magnitude of those oscillations being much stronger at first. 2. Although health-care workers may respond effectively following a disaster, they are not immune to its stresses. They must attend to the victims, regardless of their own needs, taxing even the toughest of the tough. 3. A crisis team should be established to work with the staff before disaster strikes, to be highly visible during a disaster to maintain staff support and emotional stability. They should take an active role in organizing and conducting mandatory debriefing sessions after a disaster to ward off traumatic effects.     

Surprise in Social Work Education

Training is commonly seen as the most viable way of ensuring good quality care in residential homes for elderly people. The literature on training has focused on a shift in emphasis from traditional 'professional' social work training for staff at a senior level to training which is to be provided for junior level staff. To this end, Scottish/National Vocational Qualifications have been introduced which, through workplace assessment of competence, have been proclaimed to be the means by which to raise the status and career prospects of a social care workforce. This article argues that task-based competence is increasingly being seen as relevant for a 'para-professional' social care workforce such as that found in the residential care sector. In the light of this, research was undertaken to establish whether residents preferred 'trained' staff, holding formal qualifications and/or NVQs, to 'untrained' staff with no recognised qualifications. The research concluded that residents want kind, understanding and experienced staff, and when length of time in post was taken into account, the effect of training was negligible. The study concluded that homes need to select staff for their good personal qualities and encourage them to stay. Staff need training that integrates skill with understanding and above all, assessment should reflect this perspective. Moreover, residents need to be involved in the assessment process.     

Contact networks in the emergency department: Effects of time,environment, patient characteristics,and staff role

Emergency departments play a critical role in the public health system, particularly in times of pandemic. Infectious patients presenting to emergency departments bring a risk of cross-infection to other patients and staff through close proximity interactions or contacts. To understand factors associated with cross-infection risk, we measured close proximity interactions of emergency department staff and patients by radiofrequency identification in a working emergency department. The number of contacts (degree) is not related to patient demographic characteristics. However, the amount of time in close proximity (weighted degree) of patients with ED personnel did differ, with black patients having approximately 15 min more contact with staff than non-white patients. Patients arriving by EMS had fewer contacts with other patients than patients arriving by other means. There are differences in the number of contacts based on staff role and arrival mode. When crowding is low, providers have the most contact time with patients, while administrative staff have the least. However, when crowding is high, this differential is reversed. The effect of arrival mode is modified by the extent of crowding. When crowding is low, patients arriving by EMS had longer contact with administrative staff, compared to patients arriving by other means. However, when crowding is high, patients arriving by EMS had less contact with administrative staff compared to patients arriving by other means. Our findings should help designers of emergency care focus on higher risk situations for transmission of dangerous pathogens in an emergency department. For instance, the effects of arrival and crowding should be considered as targets for engineering or architectural interventions that could artificially increase social distances.     

The Influence of Agency Staffing on Quality of Care in Nursing Homes

ABSTRACT

Data from a large sample of nursing homes were used to examine the cross-sectional association between use of agency staff, regular staff, and quality. Agency use data came from a survey conducted in 2003 (N?=?1071 nursing homes). The agency and regular staff measures were for nurse aides, licensed practical nurses, and registered nurses. We used a single quality factor constructed from the 14 quality measures in Nursing Home Compare. More agency nurse aides resulted in a smaller increase in quality, compared to the use of an equivalent number of regular nurse aides. Agency registered nurse staff were associated with better quality factor scores, especially in the presence of high levels of regular licensed practical nurses. Our results have policy and practice implications, the most significant of which is that agency registered nurses may be beneficial in a wide variety of circumstances, whereas agency nurse aides and licensed practical nurses should be used with caution.     

Principles for Developing Benchmark Criteria for Staff Training in Responsible Gambling

One approach to minimizing the negative consequences of excessive gambling is staff training to reduce the rate of the development of new cases of harm or disorder within their customers. The primary goal of the present study was to assess suitable benchmark criteria for the training of gambling employees at casinos and lottery retailers. The study utilised the Delphi Method, a survey with one qualitative and two quantitative phases. A total of 21 invited international experts in the responsible gambling field participated in all three phases. A total of 75 performance indicators were outlined and assigned to six categories: (1) criteria of content, (2) modelling, (3) qualification of trainer, (4) framework conditions, (5) sustainability and (6) statistical indicators. Nine of the 75 indicators were rated as very important by 90 % or more of the experts. Unanimous support for importance was given to indicators such as (1) comprehensibility and (2) concrete action-guidance for handling with problem gamblers, Additionally, the study examined the implementation of benchmarking, when it should be conducted, and who should be responsible. Results indicated that benchmarking should be conducted every 1–2 years regularly and that one institution should be clearly defined and primarily responsible for benchmarking. The results of the present study provide the basis for developing a benchmarking for staff training in responsible gambling.     

Bridging the gap between ecological research and land use policy: The North Sonoran Collaboration

A key factor in bridging the gap between ecological research and public land use policy is translating information from the language of research into the language of public policy making. Creating effective translations of research is often beyond the skills of urban planners and environmental researchers individually, and thus collaboration between the two is needed. Examples of such translation and partnerships can be found in the projects of an interdisciplinary group coined the North Sonoran Collaborative. This group consists of Phoenix, AZ, USA city staff, Arizona State University faculty, graduate students, and staff, and people from other local private companies and government agencies. The group, through its collaboration, has sponsored a series of environmental research efforts and translated those into successful land use planning activities and policies. The focus of the collaboration is the northern, largely undeveloped portion of the city of Phoenix, Arizona. This group has pursued three principles: desert ecosystems should be protected, a diversity of development should be pursued, and a sense of community should be created in new developments. This paper discusses this unique approach to planning and how it has proven effective in responding to the local communities needs quickly.     

Coincidence of role expectations between staff and volunteer members of drug free community coalitions

Community coalitions have proliferated as a means of addressing a range of complex community problems. Such coalitions often consist of a small paid staff and volunteer members. The present study examines one likely contributor to coalition effectiveness: the degree of agreement on role expectations between paid staff and volunteer members. Role confusion occurs when paid staff and volunteers differ in their expectations of who is responsible for accomplishing specific tasks. Staff and volunteer members from 69 randomly selected Drug Free Coalitions in the United States as well as 21 Drug Free Coalitions in Connecticut were asked to respond to an online survey asking about 37 specific coalition tasks critical for effective coalition functioning and the degree to which paid staff and/or voluntary members should be responsible for accomplishing each. Our final sample consisted of 476 individuals from 35 coalitions. Using coalitions as the unit of analysis, we found significant differences between paid staff and volunteer coalition members on nine tasks reflecting four domains: meeting leadership and participation, (2) planning and implementation leadership, (3) publicity/media relations, and (4) logistical functions. Implications of these differences and ways that evaluators could help coalitions deal with differing role expectations were discussed.     

Elusive reconciliations: ideological conflict in youth homeless shelters

This paper explores an important contradiction in the operation of youth homeless shelters: while employees may champion autonomy, stringent regulations constrict independence. Inherent in shelter life is a struggle between more symbolically powerful staff members, who exercise authority and judgment over residents in accordance with societal norms, and youth, who are compelled to feel at once independent and subject. Power differentials and the transmission of messages about worth, deservingness, and compliance should be scrutinized by shelter staff members and top leadership. Understanding how the most effective staff-resident collaboration can be initiated will require sincere consideration of the extent to which “necessary” limitations of personal liberty within an environment that pushes autonomy actually represent manifestations of symbolic processes of power.     

Abstract

Abstract

Edmunds M W: Structure and nurse practitioner performance. The Nurse Practitioner 4: (3)42, May/June 1979

Are you a “new” nurse practitioner (NP) returning to your “old” practice setting? Are you a staff nurse, physician, receptionist in the “old” setting, wondering how to cope with this “new” nurse? This article is a MUST.

Simply and clearly, Ms. Edmunds illustrates the ingredients necessary to facilitate successful role transition.

Structural aspects requiring consideration are drawn from A. Donabedian and include:

1. adequacy of physical structure, facilities and equipment—office, exam room and equipment, telephone;

2. staff qualifications and organization-different mixes and levels of staff and/or reallocation of functions may be required;

3. fiscal arrangements—economic contributions to the practice should be recognized financially;

4. administrative, organization and/or programatic structures need to be reevaluated. Daily routine, patient assignment, collaboration-consultation time, development of new modes of health care delivery are examples.

Problems that may prove to be barriers to the role transition must be assessed and defined. Solutions potentiated should include attending to the structural aspects of the practice milieu. Ms. Edmunds offers valuable suggestions to avert or resolve “reentry” problems.     

A systematic approach to smoking cessation activities in Danish shelters

Introduction: Shelter users have an alarmingly high smoking prevalence; our aim was to develop systematic smoking cessation activities in the shelters. Method: All available (n?=?13) shelters in Copenhagen were included. This Participatory Action Research had a development/test period and an implementation period for the revised intervention. Shelter-staff completed a questionnaire at baseline. Municipal smoking cessation counselors were trained to work with shelter users. Three types of on-site smoking cessation activities were developed and offered. Results: The estimated mean smoking prevalence in shelter users was 79%. Only two shelters ran smoking cessation activities prior to study start. All but one of the shelters implemented group-based intervention activities and approximately 13% of smokers signed-up; 26.6% of those who attended the first session were abstinent after approximately 12 weeks, as confirmed by staff. Conclusion: Smoking cessation activities in shelters are wanted by staff and shelter users, they are feasible and even very vulnerable persons are able to quit. Based on our experiences in Copenhagen shelters, we propose a systematic approach for future smoking cessation initiatives: smoking activities should be driven by the municipality, be pro-active, on-site, tailored and flexible, in addition, free nicotine therapy should be offered and trained smoking cessation counselors should be available.     

A Critical Look at Staff Appraisal: The Case of Women in Scottish Universities

An analysis of appraisal of women staff in Scottish universities reveals two ‘puzzles’. First, although there is a general decline in the use of appraisal schemes in these universities, women staff still have a strong sense of being subject to a disciplinary technology. Second, although appraisal and the broader disciplinary technology disadvantage women, they still want to be appraised. This article uses the critical literature on appraisal, and particularly a Foucauldian analysis of disciplinary power, to shed light on these apparent contradictions. Such an approach helps explain the first of these ‘puzzles’ but a basic conundrum for women remains — although there are demands for appraisal and normalization in the name of fairness and equity, such processes of normalization tend to be gender‐biased and hence should be resisted by women.     

坚持科学发展观 培养实用型医学检验人才

作为培养人才的卫生职业院校,其教育教学的开展要以科学发展观为指导,以检验专业为例,从师资队伍建设,到教学的整个过程,都要坚持以人为本,从而培养出适应社会需要的实用型人才。     

Self-reported ageism in students and academic staff—the case of the Social Work Department in Crete,Greece

This study focuses on self-reported ageism among social work students and academic staff in the Social Work Department of Crete, Greece; the 20-item questionnaire Relating to Older People Evaluation (ROPE) was used to measure negative and positive ageist behaviours that respondents engage in during everyday life. Positive ways of relating to old people were reported much more often than the negative ways; no significant differences in mean endorsement scores between academic staff and undergraduate students in either the positive or the negative dimensions were found. Women endorsed positive ageism items more often than men did, but the two genders did not differ in their endorsement of negative ageism items. This association was observed both for the students and academic staff. For students, no relationship between how many years they had spent studying and endorsement score was observed for either the positive or the negative behaviour items. Social work students and academic staff should be aware that positive ageism may turn into paternalism; it is important that social work education prepares students in order to approach clients with a non-prejudiced attitude and to provide them with quality services.     

Demographic Characteristics

This article aims to describe the characteristics of and design elements in gardens/patios at 87 residential living homes for older people and to describe and compare residents’ and staff members’ perceptions of outdoor spaces. The aim was also to investigate factors related to residents' satisfaction with and stays in the garden/patio. The result showed that many gardens/patios had several recommended design elements and, at the same time, obvious deficiencies. The residents (n = 415) valued various aspects of the garden/patio more highly than did the staff (n = 667). Managers responsible for residential living homes for elderly people should take measures to ameliorate deficiencies and deficient elements in design and accessibility that are lacking so that the garden/patio can be used as an important health promotion resource in the care of elderly people. Residents and staff are important actors in such development work.     

把握成人教育的特点是职工培训收到实效的关键

职工素质的高低关系到企业的生存与发展,因此,越来越多的企业开始重视对其员工的培训。企业员工培训应针对成人的学习特点,采取适合成人特点的培训模式,培训方式才能激发学员的学习兴趣,才能做到有效培训。     

Regulating behavior management practices in residential treatment facilities

Model licensing requirements were developed by the New Jersey Department of Human Services' Division of Youth and Family Services to assist child welfare/human services licensing agencies in regulating children's residential facilities that use mechanical/physical restraints, isolation and/or exclusion in order to manage the behavior of severely emotionally disturbed and acting out youths. These requirements also identified practices that should be prohibited, such as forced physical exercise, certain types of mechanical restraint and group punishment. This article highlights a number of studies that help support the rationale for the model licensing requirements. In addition, the article discusses staff ratios, policies/procedures, documentation requirements, informed consent, peer review committees and staff training.