An analysis of safety culture attitudes in a highly regulated environment

Culture is a complex construct in organizations, consisting of attitudes, perceptions, values and beliefs, which must necessarily be set in context. Many authors imply that culture is organization-wide and common to all employees. In terms of safety culture, the organizational context may determine its salience and likelihood of affecting behaviour, especially in a highly regulated environment such as the nuclear industry. This study investigates the components of safety culture and how it varies in a highly-regulated nuclear power plant. A 60-item questionnaire measuring safety attitudes and values was administered anonymously to 1550 employees at two plants in the UK nuclear industry, with a 64.7% mean response rate. Principal components analyses revealed six factors conceptually common to shop floor and management (supervisor/manager/professional) groups for both plants, relating to: management style and communication; responsibility and commitment; risk-taking; job satisfaction; complacency; and risk awareness. A canonical discriminant analysis of the items suggested that the data could distinguish three employee groups. The implications of these findings and the proposal that there are two or more safety cultures in the organization is discussed.     

An evaluation of a groupwork intervention for teenage mothers and their families

This paper describes the implementation of a specific, community‐based, multi‐family group (MFG) intervention strategy (Families and Schools Together [FAST] babies) aimed at improving the outcomes for infants of teenage mothers in 11 Canadian communities. The aims of this social work group intervention were (1) to engage the teenage mothers into a socially inclusive experience that might challenge the social disapproval they often experience, (2) to enhance the mother–infant bond, while increasing feelings of parental efficacy, and (3) to enhance the social context of the teenage mother by reducing stress, social isolation and intergenerational family conflict. Groups were co‐led by teams of service users (a young mother, a grandmother of the baby of a teenage mother and a father of the baby of a teenage mother) collaborating with multi‐agency professionals (health visitors and social workers). Teams that reflected the ethnic diversity of the participating family members were trained to facilitate eight weekly group meetings. They showed respect for the young women's ‘voice’, and supported her ‘choice’ to prioritize motherhood as her defining identity. The meetings comprised a range of activities, including crafts and singing, discussion of ‘conflict scenarios’ in cross‐familial, cross‐generational groups, infant massage delivered to babies by the young mothers, grandmother support groups, and a shared community meal. Where necessary, teams made referrals for specialist help. One hundred twenty‐eight young mothers came once to 17 groups, and 90% graduated having attended a minimum of six sessions. Evaluation data from mothers and grandmothers showed positive change when comparing pre and post, based on standardized questionnaires. One‐tailed, paired t‐tests showed statistically significant increases in parental self‐efficacy for the teenage mothers, improved parent–child bonds, reductions in stress and family conflict, and increases in social support. Given that rates of teenage pregnancy in the UK are among the highest in Europe, this paper concludes with a discussion of the feasibility and possible merits of introducing FAST babies to England.     

Family Functioning and Predictors of Runaway Behavior Among At-Risk Youth

Adolescent runaway behavior is associated with a host of negative outcomes in young adulthood. Therefore, it is important to understand the factors that predict running away in youth. Longitudinal data from 111 at-risk families were used to identify proximal predictors of runaway behavior over a 12-week period. On average, youth were 14.96 years old, and 45 % were female. Ten percent of youth ran away during the 12-week follow-up period. In bivariate analyses, running away was predicted by poorer youth- and parent-rated family functioning, past runaway behavior, and other problem behaviors (e.g., substance use, delinquency), but not poorer perceived academic functioning. Results of a hierarchical logistic regression revealed a relationship between youth-rated family functioning and runaway behavior. However, this effect became non-significant after accounting for past runaway behavior and other problem behaviors, both of which remained significant predictors in the multivariable model. These findings suggest that youth who run away may be engaged in a more pervasive pattern of problematic behavior, and that screening and prevention programs need to address the cycle of adolescent defiant behavior associated with running away. Recommendations for clinical practice with this at-risk population are discussed.     

Financial strain over the life course and health among older adults

This paper focuses on financial strain across the life course as a condition underlying health inequalities observed in later life. The analysis is based on data from 1167 adults 65 years and older collected as part of the 'Aging, Stress and Health Study". Relying on retrospective data about hardship experienced over the life course, we find that long-term financial hardship is reflected in a range of health outcomes at late life, even after controlling for the effects of current financial circumstances. Moreover, the sheer persistence of hardship matters more than its episodic occurrence or timing, so that the health effects of early hardship may be obviated if followed by no further hardship. This pattern offindings is consistent with the notion of allostatic load, the cumulative damage done to health and well-being under the burden of an unrelenting stressor in a critically important life domain.     

Detecting suicide risk in adolescents and adults in an emergency department: a pilot study

The investigators conducted a pilot study to detect suicide risk in adolescents and adults seeking treatment in an emergency department, as well as to test the reliability and validity of the 4-item Risk of Suicide Questionnaire (RSQ). This study expanded the implementation of the RSQ beyond its initial use with children and adolescents with psychiatric symptoms who were seeking treatment in a pediatric emergency department to include adolescent and adult patients in a Level I trauma center. An advanced practice psychiatric nurse verbally administered the RSQ to a convenience sample of 104 emergency department patients ages 12 to 82. Psychometric analysis demonstrated an adequate degree of reliability and criterion-related validity for the RSQ. Approximately 30% of all patients who participated screened positive for suicide risk. The results support the continued use of the 4-item RSQ with all adolescents and use of a reduced 2-item form of the RSQ with adults exhibiting psychiatric chief complaints to determine imminent risk of suicide in patients who seek treatment in the emergency department. Nurses in all health care settings need to initiate suicide screening and implement nursing interventions directed toward suicide prevention.     

Sexual functioning and practices in a multi‐ethnic study of midlife women: Baseline results from swan

This study examined the sexual practices and function of midlife women by ethnicity (African American, Caucasian, Chinese, Hispanic, Japanese) and menopausal status. Sexual behavior was compared in 3,262 women in the baseline cohort of SWAN. Participants were 42 to 52 years old, premenopausal or early perimenopausal, and not hysterectomized or using hormones. Analysis used multivariate proportional odds regression. In our sample, 79% had engaged in sex with a partner in the last 6 months, and a third considered sex to be very important. Common reasons for no sex (n = 676) were lack of partner (67%), lack of interest (33%), and fatigue (16%). Compared with Caucasians, Japanese and Chinese women were less likely, and African Americans more likely, to report sex as very important (p < 0.005). Significant ethnic differences were found for frequency of all practices. Perimenopause status was associated only with higher frequencies of masturbation and pain during intercourse.     

Changes in Admissions Work Arising from the New Social Work Degree in England

The business of admissions to higher education in England is a significant task for academic and support staff. This paper draws on the Evaluation of the New Social Work Degree Qualification in England (2004–2008) to describe the changes in admissions work for social work staff in higher education associated with the change from diploma to a degree level qualification for entry to the profession; to report how staff involved in admissions work are managing these changes; and to identify elements of admissions processes that are perceived to be fulfilling the new requirements of the degree and those which are identified as more problematic. The article draws on two telephone/email surveys of a national sample of social work programmes and on face-to-face in-depth interviews with a sample of teaching staff from nine social work programmes in six higher education institutions undertaken during 2005–2007. The work of admissions staff is rarely scrutinised in studies of higher education or specifically in social work programmes: this article discusses the spectrum of approaches. It recommends monitoring of the outcomes of practices in admissions work that are recasting Department of Health Requirements as the minimum.     

Schizophrenia Fellowship of Australia,Inc.

One of the most stigmatized health areas is mental health, so the feasibility of a self-help organization to assist those with the common mental illness, schizophrenia, was contemplated with some misgivings by the Victorian Mental Health Authority in 1977. However, as it was departmental policy to encourage community involvement in alleviating mental illness and its associated problems, a number of relatives of people with schizophrenia were contacted to assess their reaction to the proposition. The response was positive and eight relatives agreed to become a steering committee to organize a public meeting to put forward the idea of forming a self-help organization centred on schizophrenia.     

“Capacity Is Key”: Investigating New Legal Provisions in England and Wales for Adult Safeguarding

This study aimed to investigate the views and experiences of local Safeguarding Adults Coordinators of the newly implemented Mental Capacity Act 2005. This legislation in England and Wales has both protection and empowerment as its dual goals. Fifteen Safeguarding Adults Coordinators (SACs) employed by local authorities in the London area were interviewed in 2008, and again 2 years later. A total of 12 SACs participated in the 2010 follow-up interviews. The findings are reported here, covering experiences and views on the implementation and uses of the Act. There was overwhelming support for the Act as enhancing people's rights to a life free from abuse, of providing a framework for the assessment of decision-making capacity, and of assisting practitioners in reducing risks and responding to abusive situations. Participants urged better publicity about the Act, more detailed guidance on the new offenses, and greater attention to the interactions with other government policy goals.     

Recurrence of child maltreatment substantiation: findings from the administrative data of South Korea’s National Child Protection Agency

The recurrence of child maltreatment substantiation among families served by South Korea’s Child Protection Agency has yet to be thoroughly investigated. This study explores the recurrence of child maltreatment substantiation and related risk factors using the administrative data from the National Child Protection Agency (NCPA) . Multilevel discrete time-hazard analysis is employed. We found that the risk of recurrence is greatest during the first month after initial substantiation. Younger children, those with disabilities, children with a greater number of vulnerabilities, families on welfare, father-headed families and impoverished communities had a heightened risk of recurrence of child maltreatment substantiation. The implications of the findings are discussed.