Enclosed versus open nursing stations in adult acute care psychiatric settings: does the design affect the therapeutic milieu?

Specific efforts by hospital accreditation organizations encourage renovation of nursing stations, so nurses can better see, attend, and care for their patients. The purpose of this study was to examine the effect of nursing station design on the therapeutic milieu in an adult acute care psychiatric unit. A repeated cross-sectional, pretest-posttest design was used. Data were collected from a convenience sample of 81 patients and 25 nursing staff members who completed the Ward Atmosphere Scale. Pretest data were collected when the unit had an enclosed nursing station, and posttest data were collected after renovations to the unit created an open nursing station. No statistically significant differences were found in patient or staff perceptions of the therapeutic milieu. No increase in aggression toward staff was found, given patients' ease of access to the nursing station. More research is needed about the impact of unit design in acute care psychiatric settings.     

Obstacles for child participation in care and protection cases—why Norwegian social workers find it difficult

Although some attempts are being made to increase children's participation in Norwegian child protection cases, much needs to be done in order to comply with the participation principle in the United Nations Convention on the Rights of the Child. This paper reports on a study of factors that are likely to predict if social workers will attempt to give children an effective voice in decision making processes. 53 child protection case managers and 33 social work students participated in a questionnaire survey in which they were asked to agree or disagree with 20 statements about child participation. Statistical factor analysis was used in order to identify underlying factors in the dataset. The results suggest three main reasons for children not being allowed to participate: communication difficulties (communication factor); because child participation was not deemed necessary (participation advocacy factor); or that participation was considered inappropriate because it might be harmful (protectionism factor). This research suggests that, if we are to improve participation within the child protection system, formal regulations and guidelines need to be accompanied by a greater attention to development of social work skills in working with children through participatory processes. Copyright © 2010 John Wiley & Sons, Ltd.     

The effect of visualization method on the performance of simulated microsurgery tasks

The operating microscopes may be a significant cause of fatigue and discomfort in surgeons. The need for the microscope to be placed over the operating field forces surgeons to remain at the microscope's eyepieces at an uncomfortable posture for the entirety of the surgery. This study compared the effects on microsurgical task performance for four visualization methods: a monocular microscope, a binocular microscope, a three-dimensional (3D) flat-panel television display and a two-dimensional (2D) flat-panel television display. Eleven subjects each performed two microsurgical tasks and their performance was documented by video camera. The statistical analysis performed indicated utilization of the microscope as a visualization method increased subject performance. No significant difference in performance between the 2D and stereoscopic visualization methods.     

Adaptive information design for outdoor augmented reality

Augmented Reality focuses on the enrichment of the user's natural field of view by consistent integration of text, symbols and interactive three-dimensional objects in real time. Placing virtual objects directly into the user's view in a natural context empowers highly dynamic applications. On the other hand, this necessitates deliberate choice of information design and density, in particular for deployment in hazardous environments like military combat scenarios. As the amount of information needed is not foreseeable and strongly depends on the individual mission, an appropriate system must offer adequate adaptation capabilities. The paper presents a prototypical, vehicle-mountable Augmented Reality vision system, designed for enhancing situation awareness in stressful urban warfare scenarios. Tracking, as one of the most crucial challenges for outdoor Augmented Reality, is accomplished by means of a Differential-GPS approach while the type of display to attach can be modified, ranging from ocular displays to standard LCD mini-screens. The overall concept also includes envisioning of own troops (blue forces), for which a multi-sensor tracking approach has been chosen. As a main feature, the system allows switching between different information categories, focusing on friendly, hostile, unidentified or neutral data. Results of an empirical study on the superiority of an in-view navigation cue approach conclude the paper.     

How to reduce workload--augmented reality to ease the work of air traffic controllers

In the future the air traffic will rise--the workload of the controllers will do the same. In the BMWi research project, one of the tasks is, how to ensure safe air traffic, and a reasonable workload for the air traffic controllers. In this project it was the goal to find ways how to reduce the workload (and stress) for the controllers to allow safe air traffic, esp. at huge hub-airports by implementing augmented reality visualization and interaction.     

A comparative study of occupancy and patient care quality in four different types of intensive care units in a children's hospital

This paper reports a comparative study of occupancy and patient care quality in four types of intensive care units in a children's hospital,: an Infant Care Center (ICC), a Medical/Surgical (Med/Surg) unit, a Neonatal Intensive Care Unit (NICU), and a Pediatric Intensive Care Unit (PICU), each featuring a mix of multi-bed and private room (PR) patient care environments. The project is prompted by interest by the project sponsor in a pre-occupancy analysis, before the units are upgraded to exclusive PR designs. Methods comprised, for each unit: (1) observations of ergonomic design features; (2) task activity analyses of job performance of selected staff; and (3) use of a survey to collect perceptions by unit nursing and house staff (HS) of indicators of occupancy and patient care quality. Conclusions: (1) the five most common task activities are interaction with patients, charting, and interaction with equipment, co-workers and family members; (2) job satisfaction, patient care, work environment, job, patient care team interaction, and general occupancy quality rankings by ICC and/or NICU respondents are significantly higher than those by other staff respondents; and (3) ergonomic design shortcomings noted are excess noise, problems with equipment, and work environment, job-related health, and patient care quality issues.     

Interviewing children versus tossing coins: accurately assessing the diagnosticity of children's disclosures of abuse

We describe a Bayesian approach to evaluating children's abuse disclosures and review research demonstrating that children's disclosure of genital touch can be highly probative of sexual abuse, with the probative value depending on disclosure spontaneity and children's age. We discuss how some commentators understate the probative value of children's disclosures by: confusing the probability of abuse given disclosure with the probability of disclosure given abuse, assuming that children formally questioned about sexual abuse have a low prior probability of sexual abuse, misstating the probative value of abuse disclosure, and confusing the distinction between disclosure and nondisclosure with the distinction between true and false disclosures. We review interviewing methods that increase the probative value of disclosures, including interview instructions, narrative practice, noncontingent reinforcement, and questions about perpetrator/caregiver statements and children's reactions to the alleged abuse.     

Skin lighteners, Black consumers and Jewish entrepreneurs in South Africa

This article considers the rise and decline of South Africa's lucrative and controversial skin-lighteners market through examination of the business history of the largest manufacturers, Abraham and Solomon Krok, and their evolving personas as millionaires and philanthropists. Such examination reveals how the country's skin-lighteners trade emerged as part of the broader growth of a black consumer market after the Second World War and how elements of that market became the target of anti-apartheid protests in subsequent decades. It also demonstrates how the Kroks' experiences as second-generation Jewish immigrants shaped their involvement in the trade and how, later, their self-identification as Jewish philanthropists informed their efforts to rehabilitate their reputations following South Africa's 1990 ban on all skin lighteners. Such efforts include the building of Johannesburg's highly acclaimed Apartheid Museum, modelled after the United States Holocaust Memorial Museum. This article explores the profound ironies that some South Africans see in the fact that a museum dedicated to commemorating those who suffered under and, ultimately, triumphed against state racism was financed by a family fortune generated through the sale of skin lighteners to black consumers.     

An Overview of and Rationale for Changes Proposed for Pathological Gambling in DSM-5

The fifth revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is scheduled for publication in 2013. It will include several changes to the diagnosis of pathological gambling: the name of the disorder will be altered, the threshold for diagnosis will decrease, and one criterion will be removed. This paper reviews the rationale for these changes and addresses how they may impact diagnosis and treatment of the disorder, as well as potential for future research in the field.